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51 Cards in this Set

  • Front
  • Back
Define Insurance
a contract in which one party agrees to indemnify the other party against loss or damage or liability arising from an unknown event
Pure Risk
situations that can only result in a loss or no change
Speculative Risk
opportunity for either loss or gain
Which type of risk to insurance companies accept?
Only accept pure risk
Exposure
unit of measurement used to determine rates charged for insurance
What are some factors used to determine rates in Life Insurance?
age, medical history, occupation and sex
Homogenous
large number of units having same or similar exposure to loss
Hazards
conditions that increase probability of loss occurring
(physical, moral and morale)
Define physical hazards
individual characteristics that increase chance of loss
What are some examples of physical hazards?
Pre-existing medical condition, birth condition, (blindness)
Define Moral Hazards
tendencies toward increased risk
What are some examples of moral hazards
lying on an application for insurance
submitted fraudulent claims
Define Morale Hazards
indifference to loss

"i don't need to pay for the flu shot, if I get sick my insurance will pay for it"
Perils
causes of loss insured against in an insurance policy
Loss
the reduction, decrease, or disappearance of value of the person or property insured in a policy caused a peril
What are some methods of handling risks?
avoidance
retention
sharing
reduction
transfer
What certain characteristics or elements must be present before a pure risk can be insured?
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
Adverse Selection
insuring of risks that are of poorer class than the average risk
How do underwriters protect the insurer against adverse selection?
restriction of coverage
acceptance only at higher rate
refusal to accept risk
Law of Large Numbers
the larger the number of similar exposure unity considered, the more closely the losses reported will equal the underlying probability of loss.
What is the purpose of the law of large numbers?
forms the basis for statistical prediction of loss upon which rates for insurance are calculated
List the 7 types of insurers
captive
stock companies
mutual companies
fraternal benefit societies
reciprocals
risk retentions
lloyd's associations
What is the major difference between private and government insurance?
government programs are funded with taxes and serve national and state social purposes, while private policies are funded by premiums
What must an insurer have to legally transact insurance?
Certificate of Authority from the Department of Insurance
Define Domestic insurer
insurance company that is incorporated in this state
Define Foreign insurer
insurance company that is incorporated in another state, territorial possession or Washington D.C.
Define Alien insurer
company incorporated outside of U.S.
What are the 5 Marketing Systems?
Independent Agency System/American Agency System

Exclusive Agency System/Captive Agents

General Agency System

Managerial System

Direct Response Marketing System
Define Independent Agency System/American Agency System
an independent agent represents several companies and is appointed on a non-exclusive basis
define exclusive Agency System/Captive Agents
agent represents only one insurer and is appointed on an exclusive basis
Define general agency system
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
Define Managerial System
a sales force is supervised by a branch manager who, in contrast to the general agent, is a salaried employee of the insurer
Define Direct Response Marketing System
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
Name and define the general rules of agency
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
what are the three types of agent authority
express-written in contract

implied- not written but assumed

apparent- not expressed or written, but based on circumstances
What is an agent legally obligated to do?
Perform in an ethical manner
define fiduciary
agent/broker who handles insurer's funds in a trust capacity
Name some regulation in the Market Conduct
conflict of interest
request of a gift or loan as a condition to complete business
supplying confidential information
define Market Conduct
code of ethics for producers
define contract
agreement between two or more parties enforceable by law
what are the four elements to a contract?
agreement: offer/acceptance
consideration
competent parties
legal purpose
define personal contract
agreement between an insurance company and an individual that states that insurance policies cover the individual's insurable interest
define unilateral contract
contract that legally binds only one party to contractual obligations after the premium is paid
define conditional contract
type of an agreement in which both parties must perform certain duties and follow rules of conduct to make the contract enforceable
Courts have held that any ambiguity in the contract should be interpreted...
in favor of the insured
define indemnity
restoration of the insured to the same condition as prior to loss with no intent of loss or gain
What does utmost good faith imply?
there will be no fraud, misrepresentation or concealment between the parties
define representations
statements believed to be true to the best of on's knowledge, but they are not guaranteed to be true
define misrepresentations
intentionally untruthful answers
define warranty
material stipulation in the policy that if breached may void contract
define estoppel
legal impediment to denying a fact or restoring a right that has been previously waived