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Elements of Loss Exposures
- Asset Exposed to Loss
- Cause of Loss
- Financial Consequences of Loss
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Property Loss Exposures
- Real Property: Tangible property consisting of land, all structures permanently attached to the land, and whaterver is growing on the land
- Personal Property: Tangible (can be physically touched such as furniture, clothing, money, jewelry) or intangible (not physical in nature, intellectual property such as copyright or patent) property that is not real property
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Personal Property can be divided into the following categories
- Dwelling contents
- High-value personal property
- Rare or unusual property
- Business personal property
- Motor vehicles, trailers, watercraft, and aircraft
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Property Loss Consequences
- Reduction in value or property such as wrecking car
- Increased expenses such as renting a vehicle after wreck
- Lost income such as hurricane damages a rental property
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Types of Damages for Liability Losses
- General Damages: Monetary award to compensate a victim for losses that do not involve specific measurable expenses, such as pain and suffering
- Special Damages: Form of compensatory damages that awards money for specific, identifiable expenses associated with the injured person's loss, such as medical or wages
- Punitive, or Examplary Damages: Payment awarded by a court to punish defendant for a reckless, malicious, or deceitful act or to deter similar conduct; need not bear any relationship to actual damages
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Legal Sources of Liability
- Criminal Law: Defines certain activities deemed by society to be harmful to public welfare (crimes) such as murder, rape, and fraud
- Civil Law: Body of law that deals with the rights and duties of citizens regarding one another; provides means to settle disputes between parties
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Define Tort
A wrongful act or omission, other than a crime or breach of contract, commited by one party against another, for which the remedy is usually monetary damages
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Sources of Tort Liability
- Negligence
- Intentional Torts
- Absolute Liability
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Four Legal Elements of Negligence
- A duty to act
- Breach of that duty
- An injury or damage occurs
- The breach of duty is the proximate cause of the injury or damage
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Financial Consequences of Liability Losses
- Costs of investigation and defense
- Money damages awarded if the defense is not successful or settled out of court
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List the Six Steps of the Risk Management Process
- Identifying Loss Exposures
- Analyzing Loss Exposures
- Examining the Feasability of Risk Management Techniques
- Selecting the Appropriate Risk Management Techniques
- Implementing the Selected Risk Management Techiniques
- Monitoring Results and Revising the Risk Management Program
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List Six Types of Risk Control Techniques
- Avoidance
- Loss Prevention
- Loss Reduction
- Separation
- Duplication
- Diversification
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Descrive Two Risk Financing Techniques
- Retention: Losses are retained by generating funds within the organization to pay for the losses
- Transfer: Financial responsibility for losses and variability in cash flows is shifted to another party (eg. Insurance); Hold-harmless agreement
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HO Base Premium Factors
- Dwelling location
- Public protection class
- Construction factors
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HO Base Premium Adjustments
- Endorsements
- Unusual construction type
- Deductible change
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HO Final Underwriting Adjustments Relating to Risk Acceptability
- Claim history
- Insurance score
- Package policy credits
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Primary Component of Homeowners Policies
- Declarations
- Agreement and Definitions
- Section I - Property Coverage
- Section II - Liability Coverage
- Endorsements
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Section I - Property Coverages (HO)
- Coverage A: Dwelling and structure attached to dwelling such as garage or deck
- Coverage B: Other Structures not attached to dwelling such as shed, detached garages, pools
- Coverage C: Personal Property applies to contents of insured property and insured's personal property anywhere in the world such as luggage or borrowed skis that are stolen
- Coverage D: Loss of Use applies to financial loss when premises unfit for residence
- Additional Coverages subject to limitations such as debris removal, reasonable repairs
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Coverage A - Dwelling Includes (HO)
- Applies to the dwelling on the "residence premises"
- Applies to structures attached to the dwelling - such as garage or deck
- Applies to materials and supplies that are located on or next to the covered dwelling that are used to construct or repair the dwelling
- Limit should be based on the cost to replace the dwelling
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Coverage B - Other Structures (HO)
- Other structures on the residence premises that are not attached to the dwelling and are separated from the dwelling by "clear space".
- Fence or utility line does not make it an attached building
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Three Important Coverage B Exclusions (HO)
- Rented to anyone who is not a resident of the dwelling (unless rented as private garage)
- From which any business is conducted
- Used to store business property
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Coverage C Limit for Property Usually not Located at Residence (HO)
- 10% of the limit for Coverage C, or $1,000 (whichever is greater)
- Limit doesn't apply to property in a self-storage warehouse because it's not a residence
- Does not apply to personal property that is moved from the residence premises because the house is being repaired, renovated, or rebuilt and is not fit to store the property
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Special Sublimits - Coverage C (HO)
- $200 on money and precious metals
- $1,500 on securities, documents, records, and stamps
- $1,500 on watercraft, including their trailer
- $1,500 on trailers, other than those used in watercraft
- $1,500 for theft of jewelry and furs
- $2,500 for theft of firearms and related items
- $2,500 for property on the residence premises used primarily for any business purpose
- $500 for property away from the residence premises used for
- business purposes
- $1,500 for electronic apparatus equipped to be operated by power from a motor vehicle, while in or upon a motor vehicle
- $1,500 for electronic apparatus equipped to be operated by power from a motor vehicle, used primarily for business while away from the residence premises but not in or upon a motor vehicle
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Property not Covered - Coverage C (HO)
- Articles insured elsewhere, e.g., scheduled piece of jewelry
- Animals, birds, or fish
- Motor vehicles (Exception - lawn mover, motorized wheelchair)
- Aircraft
- Hovercraft
- Property of roomers or boarders unrelated to an insured
- Property in an apartment rented to others (added later as additional coverage)
- Property rented or held for rental to others off the residence premises
- Business data
- Credit card or electronic fund transfer card (added later as additional coverage)
- Water/steam (e.g., replacing water in a damaged swimming pool)
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Three coverages grouped under Coverage D (HO)
- Additional living expense
- Fair rental value
- Loss of use due to civil authority
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Additional Coverages - Coverage D (HO)
- Debris removal (additional 5% of the limit)
- Reasonable repairs
- Trees, shrubs, and other plants (no more than $500 per object)
- Fire department service charge
- Property removed
- Credit card, electronic fund transfer card or access device, forgery, and couterfeit money
- Loss assessment
- Collapse
- Glass or safety glazing material
- Landlord's furnishings - including carpeting and appliances
- Ordinance or law (comply to current: additional 10%)
- Grave markers
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Perils Exluded for Coverage A & B (HO)
- Perils Listed in the Section I Exclusions
- Collapse - however some coverage in Additional Coverage section
- Freezing of a Plumbing, Heating, Air Conditioning or Sprinkler System, or Household Appliance
- Freezing, Thawing, Pressure or Weight or Water or Ice
- Theft of Construction Materials
- Vandalism and Malicious Mischief to Vacant Dwelling
- Mold, Fungus, or Wet Rot
- Natural Deterioration
- Smoke from Agricultural Smudging or Industrial Operations
- Pollutants
- Settling of the Dwelling
- Animals
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Named Perils Covered under Coverage C (HO)
- Fire or lightning
- Windstorm of hail
- Explosion
- Riot or civil commotion
- Aircraft
- Vehicles - damages to personal property in vehicle
- Smoke - limited to sudden and accidental damage
- Vandalism and Malicious Mischief
- Theft
- Falling objects
- Weight of Ice, Snow, or Sleet
- Accidental Discharge or Overflow of Water or Steam
- Sudden and Accidental Tearing Apart
- Freezing
- Sudden and Accidental Damage from Artificially Generated Electrical Current
- Volcanic eruption
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Perils Excluded Under Section I (HO)
- Ordinance or Law - Exclude loss due to the enforcement of any ordinance or law regulating construction, repair, or demolition of buildings
- Earth Movement
- Water Damage
- Power Failure
- Neglect
- War
- Nuclear Hazard
- Intentional Loss - excludes loss arising out of an act commited by or at the direction
- Governmental Action
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Insurable Interest and Limit of Liability (HO)
- Limits the max payment for any single loss to the applicable limits, regardless of the number of insureds who might have an insurable interest
- Limits loss payment to any insured to the extent of that insured's insurable interest in the property at the time of the loss
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Your Duties After Loss (HO)
- Give prompt notice
- Notify the police
- Notify the credit card, electronic fund transfer card company, or access device company
- Protect the property from further damage
- Cooperate with the insurer
- Prepare an inventory - quantity, description, value, and amount of the loss
- Verify the loss - must show the adjuster the damaged property, allow the
- insurer to make copies of records and documents, and submit to examination under oath
- Sign a sworn proof of loss - within 60 days of insurer's request
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Settlement for Loss to a Pair or Set (HO)
- Insurer can settle loss as:
- Difference between ACV of the pair or set before and after the loss, or
- Cost to repair or replace any part of the pair or set to restore the pair or set to its value before the loss
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Definition of "Insured" under Section II
- Policyholder (named insured) and spouse if a resident of the same household ("you")
- Residents of the household who are relatives of the named insured or spouse
- Residents of the household who are under the age of 21 and in the care of the named insured or resident relatives
- Full-time student who resided in the household before moving out to attend school
- Any person or organization legally responsible for animals or watercraft that are covered by the policy and owned by a person defined in the first three bulleted items above
- Anyone employed by a person defined in the first three bulleted items, with respect to any motor vehicle covered by the policy
- Other persons using any vehicle covered by the policy on the insured location, with the consent of the named insured or spouse
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Describe Coverage F - Medical Payments to Others (HO)
Covers the necessary medical expenses incurred by others (not insured) within three years of an injury
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PAP vs. HO in Regard to Medical Payments Coverage
- PAP: Protects the insured, family members, and other passengers of the insured automobile
- HO: Medical payments to others coverage is a 3rd pary coverage that applies to others, but provides no protection for injuries to the named insured and residents of the named insureds household
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Section II - Additional Coverages (HO)
- Claim Expenses - in addition to any judgment or settlment
- First Aid Expenses
- Damage to Property of Others
- Loss Assessment
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Exclusions Common to Covs E & F (HO)
- Motor Vehicles
- Watercraft
- Aircraft
- Hovercraft
- Expected or Intended Injury or Damage
- Business
- Professional Services
- Locations that are not Insured Locations
- War
- Communicable Disease
- Sexual Molestation and Physical or Mental Abuse
- Controlled Substances
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