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40 Cards in this Set

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Personal Auto Policy (PAP)
This policy is sold primarily to cover individually owned private passenger type autos. It can be issued for a term of one year or less. PAP has the following 8 parts 1. Declarations - names, address, policy period, deductible, premiums, endorsements 2. Definitions - defines the terms used in the policy 3. Part A – this is the bodily injury and or property damage liability coverage 4. Part B – Medical Payments – this is optional coverage 5. Part C – Uninsured motorist coverage 6. Part D – Damage to our auto coverage – this would include collusion and other than collision. Part D is optional 7. Part E – Duties after an accident or loss 8. Part F – General Provisions – this would include cancellation and coverage territory
1. Who is “You and Your” or who is the named insured it’s the insured showed in the declarations as well as a spouse if a resident of the same household 2. Who is “We Us and Our” – it’s the company providing the coverage 3. What is “Your Covered Auto” a. Any vehicle shown in the declarations b. Any newly acquired auto c. Any trailer owned by the insured d. Any non-owned auto or trailer while used as a temporary substitute for any other vehicle which is out of normal use due breakdown, repair, servicing, loss or destruction 4. Newly Acquired Auto - this means any of the following types of vehicles the insured becomes the owner of during the policy period: a. Private passenger type of auto b. Pickup truck or van that is primarily used for non business purposes 5. Replacement Vehicles under Newly Acquired Auto – if a newly acquired auto replaces one shown in the declarations coverage is provided with out the insured having to ask the company to insure it. It will NOT be covered upon renewal unless identified in the declaration. 6. Additional Acquired Vehicle – If a newly acquired auto is in addition to any shown in the declarations, it will have the broadest coverage now provided for any vehicle shown in the declarations. The insured must ask the company to insure it within 14 Days after they become the owner. If the insured asks the company to insure it after 14 Days, coverage begins on the date of the request.
Coverage for damage to your auto under “Newly Acquired Auto”
Physical damage coverage for a newly acquired auto begins on the date the insured becomes the owner if: a. The newly acquired auto replaces one shown on declarations b. The company provided that coverage on the vehicle the insured replaced for at least 12 months prior to the date of replacement.
As for Coverage D-Damages
the insured must ask the company to insure it within 3 days after they become the owner. For each of the following that falls within the 3 day period the company will extend coverage for one day, i.e. Saturday, Sunday or legal holiday (max of 6 days)
Means a vehicle designed to be pulled by a private passenger type auto, pickup truck or van. It would also a farm wagon or farm implement (device) while being towed by private passenger type auto or pick up truck or van.
8. Family member
This means any person related to the named insured by blood marriage or adaption including ward and foster children who are residents of the same household.
9. Occupying
Means in, getting in; getting out; on, getting on; getting off
Part A - Liability
The Company will pay for damages for BI and or PD for which any insured becomes legally responsible because of an auto accident. The company will settle or defend as they consider appropriate any claim or suite asking for these damages. In addition to the limit of liability, the company will pay all defense and court costs they incur. The company’s duty to settle or defend ends when the limit of liability has been exhausted. The company has no duty to defend any claim not covered by the policy.
Who is an insured or covered person for Liability?
1. The names insured and family members 2. Any other person using the insured’s covers auto with permission 3. For the covered auto, any person or organization but only with respect to the legal responsibility for the acts of a person for whom coverage is afforded under this part. 4. For any non-owned auto or trailer, any person or organization but only with respect to legal responsibility for the acts of the name insured or family member for whom coverage is afforded under this part. This provision applies only if the person or organization does not own or hire the auto or trailer.
Part A –Liability: Limits of Liability
The minimum limits of liability in NY are as follows: 1. On a split limit basis coverage is for 25K BI per person per accident, 50k total BI per accident and 10k property damage per accident. (25/50/10) 2. On a Combined Single Limit (C.S.L) basis coverage is for 60k – Combined single limit means BI and PD are combined under one single limit.
New York State Statutory Death Benefits
If the limit shown in the policy is less than $100K BI per person per accident and $200K BI total per accident and the accident results in death, the policy will pay up to $50K BI for the death of any one person and up to $100K BI for the death of 2 or more. This is additional insurance.
*Part A - Liability Supplementary Payments
In addition to their limit of liability the company will pay on behalf of an insured: 1. All defense and court costs they incur 2. Up to $250 for the cost of bail bonds required because of an accident 3. Premiums on appeal bonds and bonds to release attachments. 4. Interest accruing after a judgment is entered in any suit the company defense 5. Up to $200 a day for loss of earning because of attendance at a hearing or trial at the company’s request. 6. Other reasonable expenses incurred by an insured at the company’s request. 7. Expenses incurred by a covered person for the first aid to others at the time of accident
Part A - Liability Exclusions:
1. Any insured who intentionally causes or directs another person to cause BI or PD 2. For property damage to property owned by or being transported by the insured 3. Bodily injury to an employee during the course of employment this exclusion does not apply to a domestic employee unless workers comps benefit’s are required or made available for that domestic 4. Any vehicle used to transport persons or property for a fee. This exclusion does not apply to share the expense car pools 5. While the insured is engaged in the business of selling, repairing, servicing, storing and parking automobiles 6. Any person using a vehicle without the belief that they are entitled to do so (thief) 7. Any vehicles having less than 4 wheels 8. Any vehicle designed or use mainly off public roads unless such vehicle is being used for medical emergency.
Out of State Coverage
If an auto accident occurs to a covered auto in any state or province other than the one in which it is principally garaged the policy for the purpose of that accident will be interpreted as follows: 1. If the State or Province has a law specifying limits of Liability for BI and or PD that are higher than the limits shown in the declarations the policy will provide the higher specified limit 2. If the State or Province has a law requiring non residents to maintain insurance when using a vehicle in that State or Province the policy will provide at least the minimum types and amounts of coverage.
Other Insurance Clause
If there is other liability insurance the company will pay only their proportion of loss that their limit of liability bears to the total of all limits. However, insurance provided for non-owned autos is excess coverage.
Part B- Medical Payments
This is optional coverage and if purchased it would be excess to no fault. If purchased the company will pay the reasonable expenses incurred for necessary medical and funeral services because of because of bodily injury caused by an accident and sustained by an insured. The company will pay those expenses for services rendered within 3 years after the date of the accident. Insured as used in this part means: any person occupying your covered auto and also extends coverage to the named insured and family member when struck as a pedestrian.
Part C- Uninsured Motorist Coverage*-
The company will pay the compensatory damages which an insured is legally entitled to recover from the owner/operator of an uninsured motor vehicle because of bodily injury caused by an accident and sustained by an insured. Insured as used in this part means: 1. The named insured and family members 2. Any other person occupying your covered auto
The Statutory Uninsured Motorist Coverage limits are:
$25K BI/pp/accident $50K/total per accident This applies to accidents that occur in NY State only
Underinsured Motorist
There is a BI, liability bond or policy does apply at time of accident but the company denied coverage or becomes insolvent. The limits are less than the limits insured carries for this coverage and is insufficient to pay the damages awarded
Supplemental Uninsured/Underinsured Motorists Coverage Endorsement (SUM)
This endorsement is available up to a limit of $250/BI/pp/accident and $500/BI total/accident but never more than the insured’s own Part A limits. This endorsement extends the limits to accidents that occur outside NY State as well but within the coverage territory. This endorsement is written on a non-stacked basis which means the at fault 3rd party’s limits are included within the insured’s Part C limits.
Part D- Damage to your Auto- Insuring Agreement
This part Covers Payment for direct and accidental loss to the insured’s covered auto or non-owned auto including equipment less any deductible indicated in the policy. Loss caused by collision will only be paid if the declarations indicate that such coverage is provided.
Means the upset or the striking with another vehicle or object by the covered auto or non-owned auto
The following types of losses are considered to be Other Than Collision (OTC):
1. Missiles and falling objects 2. Fire 3. Theft or larceny 4. Explosions or earthquake 5. Windstorm 6. Hail, water and flood 7. VMM 8. Riot and civil commotion 9. Contact with bird or animal 10. Breakage of glass – If the breakage is caused by a collision the insured may elect to have this considered a collision loss.
*Transportation Expenses
In addition, the company will pay up to $20 a day subject to maximum of $600 for transportation expenses incurred by the insured in the event of loss to the auto. If the loss is caused by total theft of the auto coverage begins 48 hours after the theft and ends when the company has paid for its loss. For losses other than total theft, coverage begins 24 hours after the auto is withdrawn from use.
Part D- Exclusions
1. Loss while the vehicle is being used to transport persons or property for a fee this exclusion does not apply to share the expense of car pool 2. Damage due and confined to wear and tear, freezing, mechanical or electrical failure or road damage to tires. Note: these would be covered if they were following an directly related to the total theft of the auto 3. Loss due to or as a consequence of radioactive contamination, discharge of a nuclear accident, war including rebellion, revolution, invasion, enemy attack and civil war. 4. Loss to equipment designed for the reproduction of sound unless the equipment is permanently installed in the auto. Also, excludes loss to tapes, cds, records, or any other equipment intended for use with such sound equipment. 5. Loss to Citizens Ban (CB) radio, 2 way mobile radio, telephone or scanning monitor unless the equipment is permanently installed in the vehicle. 6. Loss to custom furnishings in or upon any pickup truck or van 7. Loss to camper body or trailer not shown in the declarations. This exclusion does not apply to a newly acquired camper body or trailer the insured acquires during the policy period and asks the company to insure it within 14 days after they become the owner. 8. Loss to a radar detector 9. Loss to any known auto or trailer while engaged in the business while selling, repairing, servicing storing and parking auto mobiles 10. Intentional acts in the part of the insured 11. Loss resulting from the seizure or destruction by civil authorities
Part D - Limit of Liability
The Company’s limit if liability for loss will be the lesser of: 1. The ACV of the stolen or damaged property 2. The amount necessary to repair or replace the property with other property of a like kind and quality. However, the most the company will pay for loss to a. Any non owned auto which is a trailer is $500 b. Equipment designed solely for the reproduction of sound which is installed in locations not used by auto manufacturer for the installation of such sound equipment is $1000
Part D - Deductibles
Deductibles apply to both collision and other than collision. The standard deductible is $200. (Note: full glass coverage means the deductible does not apply to glass losses.
Cancelations under Auto
the company may cancel as follows: 1. For non payment of premium 15 days notice 2. Any other reason 20 days notice 3. For non renewal cancelations at least 45 days but not more than 60 is required
**NY State Comprehensive Motor Vehicle Insurance Vehicle Reparations Act. aka: Personal Injury Protection (PIP)
this is our No Fault Coverage
Personal Theft Policy
this is homeowner’s theft coverage sold separately (this works for ppl on Fair Plan)
Comprehensive Personal Liability Policy
this is homeowner’s liability coverage sold separately. (this works for ppl on Fair Plan)
*Personal Umbrella Policy – aka Excess Liability
– This provides coverage on a combined single limit basis for bodily injury, property damage and personal injury. (Note: For losses that are not covered by the underlying policy but is covered in the umbrella policy then the umbrellas coverage begins after the insured has satisfied a Self Retention Limit (deductibles) this limit is typically $1,000).
National Flood Insurance Program (NFIP)
The flood program was established by the National Flood Insurance Act of 1968. It is administered by the Federal Insurance Administrator through the Federal Emergency Management Agency (FEMA). Coverage is available for buildings and contents against loss by "Flood."
The NFIP's Dwelling Form offers coverage for
1. Building Property, up to $250,000 2. Personal Property (Contents), up to $100,000. Emergency Program offers coverage for Buildings up to $35,000 and Contents up to $10,000 "Flood" means a general and temporary condition of inundation's of two or more acres of normally dry land areas or of two or more properties, at least one of which is the insured's property from: 1. The overflow of inland or tidal waters. 2. The unusual and rapid accumulation of run-off of surface waters. 3. Mudflow. 4. Collapse of shoreline land due to erosion by waves or currents exceeding the anticipated levels that result in flood as defined above. There is a standard deductible in flood of $500. In order to be eligible to participate in the flood program a community must: 1. Adopt land use and control measures 2. Make an application to FEMA There is a 30-day wait for the binding of coverage except for a new purchase or refinance.
Transportation Insurance
The following 3 policies serve different purposes but are usually similar as to perils insured against and exclusions. The usual named perils are: Fire, lightening, bridge collapse, flood, earthquake, windstorm, theft and collision or overturning. The usual Exclusions are: War, nuclear, inherent vice, delay or loss of market, strikes, infidelity of the insured or employees, money, securities and jewelry.
Motor Truck Cargo Policy: (own trucks, not goods)- (Carriers Legal Liability Form)
this insures a trucking common carrier for legal liability arising out of loss or damage to the shippers goods caused by the above perils. The carrier is, however, responsible for most losses except for losses such as: War, nuclear, neglect of shipper. Therefore, the carrier may wind up self-insuring those losses not covered.
Interstate Commerce Commission endorsement (ICC Endorsement):
To comply with federal regulation, this endorsement converts the policy to All Risk but only for the benefit of the shipper. If the insurance company has to pay and the peril was not insured, the insurance company gets reimbursed by the common carrier. (Note: Cancellation of this policy for any reason requires 30 days advance notice be given to the ICC).
2. Transportation Policy
This policy is taken out by the shipper. It insures the shipper for loss or damage only while their goods are in the hands of a common carrier. This is offered in 2 versions: 1. Trip Transit- this covers a one time shipment 2. Open Policy- covers continuous, ongoing shipments
Advantages to a transportation policy:
1. Prompt payment of claims to the shipper 2. Higher limits of coverage than provided under the “Bill of Lading”
Motor Truck Cargo Policy (own truck, own goods) the Owners Form
This insures the owner’s goods on trucks owned or leased to the named insured when no common carrier is involved. (No bailment)