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51 Cards in this Set
- Front
- Back
Define Insurance
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a contract in which one party agrees to indemnify the other party against loss or damage or liability arising from an unknown event
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Pure Risk
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situations that can only result in a loss or no change
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Speculative Risk
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opportunity for either loss or gain
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Which type of risk to insurance companies accept?
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Only accept pure risk
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Exposure
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unit of measurement used to determine rates charged for insurance
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What are some factors used to determine rates in Life Insurance?
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age, medical history, occupation and sex
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Homogenous
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large number of units having same or similar exposure to loss
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Hazards
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conditions that increase probability of loss occurring
(physical, moral and morale) |
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Define physical hazards
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individual characteristics that increase chance of loss
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What are some examples of physical hazards?
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Pre-existing medical condition, birth condition, (blindness)
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Define Moral Hazards
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tendencies toward increased risk
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What are some examples of moral hazards
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lying on an application for insurance
submitted fraudulent claims |
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Define Morale Hazards
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indifference to loss
"i don't need to pay for the flu shot, if I get sick my insurance will pay for it" |
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Perils
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causes of loss insured against in an insurance policy
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Loss
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the reduction, decrease, or disappearance of value of the person or property insured in a policy caused a peril
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What are some methods of handling risks?
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avoidance
retention sharing reduction transfer |
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What certain characteristics or elements must be present before a pure risk can be insured?
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loss must be due to chance
loss must be definite and measurable loss must be statistically predictable loss cannot be catastrophic loss exposure to be insured must be large insurance must not be mandatory |
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Adverse Selection
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insuring of risks that are of poorer class than the average risk
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How do underwriters protect the insurer against adverse selection?
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restriction of coverage
acceptance only at higher rate refusal to accept risk |
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Law of Large Numbers
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the larger the number of similar exposure unity considered, the more closely the losses reported will equal the underlying probability of loss.
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What is the purpose of the law of large numbers?
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forms the basis for statistical prediction of loss upon which rates for insurance are calculated
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List the 7 types of insurers
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captive
stock companies mutual companies fraternal benefit societies reciprocals risk retentions lloyd's associations |
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What is the major difference between private and government insurance?
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government programs are funded with taxes and serve national and state social purposes, while private policies are funded by premiums
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What must an insurer have to legally transact insurance?
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Certificate of Authority from the Department of Insurance
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Define Domestic insurer
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insurance company that is incorporated in this state
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Define Foreign insurer
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insurance company that is incorporated in another state, territorial possession or Washington D.C.
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Define Alien insurer
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company incorporated outside of U.S.
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What are the 5 Marketing Systems?
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Independent Agency System/American Agency System
Exclusive Agency System/Captive Agents General Agency System Managerial System Direct Response Marketing System |
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Define Independent Agency System/American Agency System
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an independent agent represents several companies and is appointed on a non-exclusive basis
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define exclusive Agency System/Captive Agents
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agent represents only one insurer and is appointed on an exclusive basis
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Define general agency system
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general agent is an entrepreneur authorized by the insurer that he or she represents on an exclusive basis to sell life insurance in a specified territory and to appoint subagents
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Define Managerial System
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a sales force is supervised by a branch manager who, in contrast to the general agent, is a salaried employee of the insurer
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Define Direct Response Marketing System
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a company which advertises its insurance through the mail, internet, tv or other amss marketing and requires the applicant to complete and return the application directly to the insurer by mail or online
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Name and define the general rules of agency
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insurer as principal- acts of an agent/producer, while acting within the scope of their authority are the acts of the insurer
producer/insurer relationship- agent will always be deemed to represent the insurer, not the insured authority and powers of producers- agency contract details the authority an agent has within his/her company |
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what are the three types of agent authority
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express-written in contract
implied- not written but assumed apparent- not expressed or written, but based on circumstances |
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What is an agent legally obligated to do?
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Perform in an ethical manner
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define fiduciary
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agent/broker who handles insurer's funds in a trust capacity
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Name some regulation in the Market Conduct
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conflict of interest
request of a gift or loan as a condition to complete business supplying confidential information |
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define Market Conduct
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code of ethics for producers
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define contract
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agreement between two or more parties enforceable by law
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what are the four elements to a contract?
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agreement: offer/acceptance
consideration competent parties legal purpose |
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define personal contract
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agreement between an insurance company and an individual that states that insurance policies cover the individual's insurable interest
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define unilateral contract
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contract that legally binds only one party to contractual obligations after the premium is paid
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define conditional contract
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type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable
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Courts have held that any ambiguity in the contract should be interpreted...
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in favor of the insured
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define indemnity
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restoration of the insured to the same condition as prior to loss with no intent of loss or gain
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What does utmost good faith imply?
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there will be no fraud, misrepresentation or concealment between the parties
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define representations
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statements believed to be true to the best of on's knowledge, but they are not guaranteed to be true
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define misrepresentations
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intentionally untruthful answers
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define warranty
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material stipulation in the policy that if breached may void contract
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define estoppel
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legal impediment to denying a fact or restoring a right that has been previously waived
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