L1. General Insurance Concepts

  1. The uncertainty about loss that exists whenever more than one outcome is possible is called:



    • B) Risk
    • Explanation: (General Insurance Concepts)
    • Risk is the chance or uncertainty of loss. A hazard is something that increases the risk. The word indemnity means to pay or to reimburse the insured for covered losses. The principle of indemnity states that an insurance policy cannot pay you more than you actually lost.
  2. Insurance is a means of:



    • D) Transferring risk
    • Explanation: (General Insurance Concepts)
    • Insurance is defined as the transfer of risk in consideration of a premium paid. If you drive without auto insurance, you are retaining the risk by self-insuring. If you take the bus, you are avoiding the risk. If you sell your car, you are eliminating risk.
  3. In the formation of a legal contract, each party must give something of value. Under contract law, this is referred to as



    • B) Consideration
    • Explanation: (General Insurance Concepts)
    • Consideration is defined as the exchange of values. A client exchanges a small certain amount (the premium) for a large uncertain amount (the possibility of a claim). The Principle of Indemnity states that you cannot recover more than you lost.
  4. A prospect's statements made in the application for insurance, constitute a part of which of the following?



    • D) Consideration Clause
    • Explanation: (General Insurance Concepts)
    • The Consideration Clause states, "In consideration of the premium paid and the statements and answers contained herein, I hereby apply for life insurance with ........" The Incontestability Clause states that the insurance company may not contest a claim for any reason after the policy has been in force for two consecutive years. The Subrogation Clause has to do with Liability insurance and the Co-Insurance Clause has to do with Major Medical (Health) insurance.
  5. The exchange of value is a prerequisite to a valid insurance contract, as stated in which of the following required elements of a legal contract



    • C) Consideration
    • Explanation: (General Insurance Concepts)
    • Consideration, which is an exchange of values between the parties entering the contract, is an element that is required in order for a contract to be considered legally enforceable. Although it may be, it is not required to be equal.
  6. If agent Mike fills out an application for customer Fred and the insurer issues the policy, who has made the offer:



    • B) The Insurer
    • Explanation:
    • This is probably a COD (collect on delivery) application, since the question does not say that Fred paid any premium. On a COD application, it is the insurer who makes the offer and it is the applicant who accepts the offer by paying the premium upon policy delivery.
  7. A condition that could result in a loss is known as a(n)



    • C) Exposure
    • Explanation: (General Insurance Concepts)
    • A condition that could result in a loss is known as an "exposure". For example, being exposed to asbestos over a period of time could cause lung cancer.
  8. In an insurance contract, the insuring agreement contains which of the following



    • C) Insurer’s promise to pay
    • Explanation: (General Insurance Concepts)
    • The insuring agreement in an insurance contract contains the insurer's promise to pay covered claims.
  9. Which of the following terms means that an insurance contract may be of unequal benefit to one party or the other



    • D) Aleatory
    • Explanation: (General Insurance Concepts)
    • Aleatory means that the consideration is not necessarily equal. A valued contract is like life insurance, where the insurer agrees to pay a specified amount upon the death of the insured, regardless of their human life value. All insurance contracts are unilateral, meaning one-sided. The doctrine of adhesion states that any vague language in an insurance contract will be construed against the insurance company, since they wrote it.
  10. An insurer with a Certificate of Authority in this State is known as a(n):



    • B) Authorized Insurer
    • Explanation: (General Insurance Concepts)
    • Virtually all insurers doing business in this state must obtain a Certificate of Authority from the Commissioner authorizing them to do business in this State. An "authorized" insurer is also known as an "admitted" insurer.
  11. The authority which is given by the insurer that is not specified is which of the following:



    • B) Implied
    • Explanation: (General Insurance Concepts)
    • The authority an insurer grants a producer that is specified is express authority. The authority which is given by the insurer that is not specified, but needed to conduct customary business practices, is implied authority.
  12. All of the following choices are true about "insurance," EXCEPT



    • D) Insurance is a mechanism for handling speculative risk
    • Explanation: (General Insurance Concepts)
    • Speculative risk, like the chance of winning the lottery, is not insurable.
  13. Which type of licensee may legally represent an "unauthorized" insurer, such as Lloyds of London:



    • D) A Surplus Lines Broker
    • Explanation: (General Insurance Concepts)
    • Surplus Lines Brokers represent "unauthorized" insurers, such as Lloyds of London. Producers represent the insurer. A service representative works for an insurance company in a marketing capacity. An independent producer may represent as many insurers as they want and is paid on a straight commission basis.
  14. Under contract law, the actions by a party may intentionally and voluntarily give up a known right. When this occurs, it is known as:



    • D) Waiver
    • Explanation: (General Insurance Concepts)
    • Waiver is defined as the voluntary giving up of a legal right. The doctrine of estoppel states that once you voluntarily waive a legal right, you can't get it back.
  15. Which of the following contractual elements consists of the "offer" and the "acceptance"



    • A) Mutual Agreement
    • Explanation: (General Insurance Concepts)
    • Mutual agreement of the parties is also known as offer and acceptance. The client makes the offer when they sign the application and write the initial premium check. The underwriter accepts the risk by issuing the policy.
  16. All of the following are true about "speculative risk," EXCEPT



    • A) Speculative risk is a feature of insurance
    • Explanation: (General Insurance Concepts)
    • Only pure risk is insurable, which is defined as the chance of loss without any possibility of gain. Speculative risk, like investing in the stock market that has the chance of gain or loss, is not insurable
  17. Which of the following meets the definition of an alien insurer:



    • B) An insurer organized under the laws of Canada
    • Explanation: (General Insurance Concepts)
    • An insurer organized in another country is considered an alien insurer.
  18. Because an insurer writes the policy language and the insured has little or no control over the content, any ambiguity in the wording is usually resolved in favor of the insured. Because the design and wording of a policy are in the hands of the insurer, insurance policies are said to be:



    • B) Contracts of adhesion
    • Explanation: (General Insurance Concepts)
    • The Doctrine of Adhesion states that any ambiguity in an insurance contract is always construed against the party who wrote it, the insurer. This is why the insured often wins in court, since they have to buy the policy on a "take it or leave it" basis, without any negotiation.
  19. An independent producer:



    • D) Represents more than one insurance company
    • Explanation: (General Insurance Concepts)
    • Captive or exclusive producers work for only one insurer and are often company employees. Independent producers are self-employed and usually represent more than one insurer on a straight commission basis.
  20. The authority of an insurance producer that is spelled out in the written words of the agency contract between the producer and the insurer is:



    • C) Express authority
    • Explanation: (General Insurance Concepts)
    • Express authority is written down or "expressed" in your producer's contract. Implied authority is the authority a producer has based on the reasonable expectations of their customers. Apparent authority is the authority created when the action or inaction of an insurer gives the impression that such authority exists.
  21. When someone considers buying a business, but elects not to do so, it is known as risk:



    • D) Avoidance
    • Explanation: (General Insurance Concepts)
    • Risk is defined as the chance, probability, or uncertainty of loss. Once identified, risk may be avoided, reduced, retained or transferred. Most people transfer their risk by purchasing insurance.
  22. An insurance company owned by its policyholders, who receive a return of unused premiums in the form of policy dividends, is a(n):
    A Assessment insurer
    B) Stock company
    C) Fraternal insurer
    D) Mutual company
    • D) Mutual company
    • Explanation: (General Insurance Concepts)
    • A mutual company has no stock although it is a corporation. Ownership of the company rests with the policyholders, who might receive a dividend from accumulated surplus, if declared. Dividends are not guaranteed. Dividends paid by mutuals are not taxable. A stock company is owned by shareholders, who have "equity" in the company. The stockholders may also receive dividends, which are taxable. Stock companies issue "non-participating" policies. A fraternal insurer is non-profit with a lodge system that sells L&H insurance only to their own members.
  23. When the outcome of a contract depends upon chance, the contract is said to be:



    • D) Aleatory
    • Explanation: (General Insurance Concepts)
    • Insurance policies are "aleatory", in that the insured may have a claim and they may not.
  24. Which of the following insurance doctrines states that ambiguities in a policy will always be construed against the insurer:



    • B) Adhesion
    • Explanation: (General Insurance Concepts)
    • Under the doctrine of "adhesion", ambiguities in an insurance policy are always construed against the insurer who wrote the policy.
  25. In property and casualty and in medical-expense insurance, the principle of making someone "whole" again after a loss by paying only for actual losses is called:



    • C) Indemnity
    • Explanation: (General Insurance Concepts)
    • The Principle of Indemnity states you cannot make a profit from insurance. Subrogation is a provision that allows your insurance company to stand in your place to recover moneys they have already paid you.
  26. If the policy language is unclear, an insurer may elect to pay the claim under the doctrine of:



    • C) Reasonable expectations
    • Explanation: (General Insurance Concepts)
    • The doctrine of "reasonable expectations" states that an insurance policy should cover what a prudent person would expect that it would.
  27. The applicant's initial premium and the answers they provided on the application make up which of the following:



    • B) Consideration clause
    • Explanation: (General Insurance Concepts)
    • In order for an insurance policy to be legally enforceable an exchange of values must occur, which is referred to as consideration. The applicant's consideration is the premium they pay, and the answers they provide on the application. The insurer's consideration is their promise to provide coverage. Consideration is not required to be equal, but must be present.
  28. If someone frequently has physical exams completed they are using the following risk management technique:



    • A) Reduction
    • Explanation: (General Insurance Concepts)
    • Taking an annual physical exam is a form of risk reduction.
  29. Some producers supervise all of an insurance company's business within a specified territory. These producers appoint other producers, supervise their business, and receive an overriding commission on that business. What is the formal name for this type of producer?



    • A) Managing General Agent
    • Explanation: (General Insurance Concepts)
    • A Managing General Agent (MGA) is like a sales manager who is responsible for recruiting and training producers on behalf of an insurer in a specific territory. They need a special MGA license and are compensated on a commission over-ride basis.
  30. A moral hazard:



    • D) Is the tendency to create a loss on purpose, to collect from the insurance company
    • Explanation: (General Insurance Concepts)
    • A moral hazard is created by a dishonest person, such as someone who may use arson to collect on their fire insurance. Moral hazards are best spotted by the producer, who is considered to be the "front line" underwriter.
  31. When an insurance applicant makes a statement, to the best of their knowledge, on an application that becomes part of the contract, the statement is considered to be a:



    • A) Representation
    • Explanation: (General Insurance Concepts)
    • Representations are defined as the truth to the best of your knowledge and are required on insurance applications. Warranties are defined as something you guarantee to be true, and are usually not required, although some P&C policies ask that the customer "warrant" that a loss prevention device (such as a burglar alarm) has been installed in order to get a rate reduction.
  32. All of the following are required elements of a legal contract, EXCEPT:



    • B) Waiver and Estoppel
    • Explanation: (General Insurance Concepts)
    • Waiver and Estoppel are legal doctrines, but are not parts of the contract.
  33. An insurer incorporated under the laws of the state in which it is operating is considered to be a(n):



    • C) Domestic insurer
    • Explanation: (General Insurance Concepts)
    • A domestic company has their home office in this state. A foreign company is in another state and an alien company is in another country.
  34. A producer is a representative of:



    • A) The insurance company
    • Explanation: (General Insurance Concepts)
    • Producers represent the insurer. Under the Doctrine of Agency, insurers are responsible for what their producers do.
  35. The authority that a producer has that is based upon their actions and deeds is known as __________ authority:



    • B) Apparent
    • Explanation: (General Insurance Concepts)
    • Producers (agents) have 3 types of authority: express, which is written in their contract; implied, which is based on common industry practices; and apparent, which is based upon their prior actions or deeds.
  36. Which of the following is not one of the available methods for dealing with an exposure to risk:



    • D) Ascertain the risk
    • Explanation: (General Insurance Concepts)
    • Once a risk is identified, it can be dealt with in several ways. Self insurance is risk retention. Insurance is defined as the transfer of risk. Avoiding risk is difficult.
  37. Who within the insurer determines if a risk is acceptable:



    • B) Underwriter
    • Explanation: (General Insurance Concepts)
    • It is the underwriter that is responsible for determining if an applicant is acceptable, and if so, at what rate.
  38. In which company may stockholders share in the profits and losses of the insurer:



    • C) Stock
    • Explanation: (General Insurance Concepts)
    • Stockholders may receive dividends from the shares of stock they own in a stock company. These dividends are not guaranteed, but if paid, are taxable as ordinary income.
Author
EdiesTeam
ID
315665
Card Set
L1. General Insurance Concepts
Description
General Insurance Concepts Life Section 1
Updated