limited lines tx insurance

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reserve account
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amount set aside to pay claims so insurance does not lose money
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exclusions
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things insurers do not intend to cover
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intentional acts
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done on purpose
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non-currency
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more than one insurers at risk and policy do not match
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pro-rata
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we only pay for what we get ex: like a pizza, you only pay the slices you eat
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equal shares
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EQUAL CONTRIBUTIONS
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liberalization cause
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LIBERALIZATION A PROPERTY INSURANCE CLAUSE THAT EXTENDS BROADER LEGISLATED OR REGULATED COVERAGE TO CURRENT POLICIES, AS LONG AS IT DOES NOT RESULT IN A HIGHER PREMIUM. LOCATED IN THE CONDITIONS (liberals give stuff away)
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appraisal clause
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used for agreement on the value of a loss
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assignment
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transfer title rights of policy to another person
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at any times you -can cancel before 60 days after 60 days we would need a specific reason
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insured can cancel
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DICED D-declarations I-insuring agreement C-conditions E-exclusions D-definitions
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DECLARATIONS-the who,what,where, and how much INSURING AGREEMENT- agreement between insurance employee and the customer. CONDITIONS-customers and insurance have duties EXCLUSIONS-explains items will not be covered DEFINITIONS-used to clarify what the policy will cover
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endorsments
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add, modify, delete, info on a policy
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per accident
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amount paid for one accident
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per person
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maximum limit for any one person.
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bodily injury
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IF YOU INJURE SOME ONE IN AN AUTOMOBILE ACCIDENT FOR WHICH YOU ARE LEGALLY TO BLAME, THIS COVERAGE WILL PAY CLAIMS FOR INJURY OR DEATH AGAINST YOU AND THE COST OF LEGAL DEFENSE.
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bailee
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someone you voluntarily give your property to. they are not insured under the insured’s policy
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Period is 72 hrs to be considered an occurance
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volcanic eruption
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STARR
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Share- insurance companies share the risk \”reinsurance\” Transfer- when risk is shifted to another (buying insurance) Avoid- avoiding risk/certain activities Reduce- take steps to prevent chance of loss occurring (smoke alarms) Retain- person or entity has money to cover loss and does not buy insurance
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ADMINISTRATIVE LAW JUDGE
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such a judge does not sit as a law judge and the power is essentially one of recommendation
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class B felony
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any person who knowingly violates this section of unlicensed activities is guilty of a _____.
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CHAPTER 2
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CHAPTER 2
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STOCK COMPANIES
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OWNED BY STOCK HOLDERS OR SHAREHOLDERS
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MUTUAL COMPANIES
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OWNED BY POLICY HOLDERS
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SELF-INSURERS
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INDIVIDUAL OR COMPANIES THAT DO NOT BUY INSURANCE. THEY TAKE THE MONEY THEY WOULD USE TO PAY PREMIUMS AND USE IT INSTEAD TO PAY LOSSES
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RE INSURES
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RE INSURANCE IS INSURANCE FOR INSURANCE COMPANIES
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LLOYDS PLANS
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FREEDOM TO CHARGE AN ADEQUATE RATE WITHOUT HAVING TO GET APPROVED BY TEXAS DEPT OF INSURANCE (DO NOT PUT LLOYDS OF LONDONS HAS NOTHING TO DO WITH LOYYDS PLANS)
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WRITE
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=SELL
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PRIVATE INSURANCE
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SELL INSURANCE TO MAKE PROFIT
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GOVERNMENT INSRUANCE
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SELL INSURANCE THAT PRIVATE CARRIES DONT WANT TO SELL EX: FLOOD INSURANCE, CROP HAUT, OR FOR TEXAS WIND AND HAIL COVERAGE
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GOVERNMENT INSURANCE
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IS ALSO CALLED RESIDENTIAL INSURANCE
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DOMESTIC
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IN TEXAS
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FOREIGN
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IN THE US BUT NOT IN TEXAS
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ALIEN
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IN A DIFFERENT COUNTRY
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AUTHORIZED INSURERS
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ALSO KNOWN AS ADMITTED INSURERS (THEY ARE LEGAL. TDI)
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NON-ADMITTED
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ALSO KNOWN AS SURPLUS LINES THE (WRITE) SELL WHAT ADMITTED COMPANIES DONT WANT
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INSURANCE POLICIES
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ARE CONTRACTS BETWEEN THE INSURED AND THE INSURERS
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INDEMNITY
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PUT YOU BACK FINANCIALLY (NOT EMOTIONALLY) INSURED WILL NOT PROFIT
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CONTRACTS OF ADHESION
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\”STUCK\” WITH WHATEVER THE INSURER PUTS IN THE POLICY
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THE DOCTORINE OF REASONABLE EXPECTATIONS
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WHEN INSURED BUYS A POLICY THEY EXPECT IT WILL PREFORM BASED ON THEIR UNDERSTANDING BECAREFUL WITH POLICY WILL EXPLAIN EXACT COVERAGE
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BREACH OF WARRANTY
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YOU VIOLATE YOUR PROMISE
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BINDER
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TEMPORARY CONTRACTS GOOD FOR 30 DAYS
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REPRESENTATION
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WHAT YOU BELIEVE AT THAT MOMENT
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MISREPRESENTATION
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A FALSE STATEMENT OR FACT EX: YOU DIDN’T KNOW IT WAS CRASHED
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CONCELMENT
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IS A FORM OF MISREPRESENTATION YOU DO NOT RELEASE ALL FACTS.
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FRAUD
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AN INTENTIONAL LIE
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WAIVER
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YOUR GIVING UP YOUR RIGHTS
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ESTOPPLE
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STOPPING AN AGENT FROM HARMING THE COMPANY WITH MISLEADING INFORMATION
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DEPRECIATION
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REDUCTION IN VALUE THAT OCCURS OVERTIME (ACTUAL CASH VALUE)
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SALVAGE
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THE LEFT OVERS AFTER LOSS
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APPRAISAL CLAUSE CAN BE INITIATED
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IF A DISPUTE ARISES ABOUT PROPERTY VALUES DAMAGES OR AMOUNT OF LOSS
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APPRAISAL CLAUSE
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APPRAISAL PROCESS ID USED FOR THE AMOUNT OF LOSS IT IS FOUND IN THE CONDITIONS SECTIONS OF THE POLICY
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THE CAN HIRE AN INDEPENDENT UMPIRE IF THEY CANT AGREE ON AN UMPIRE, THEN THE COURT WILL ASSIGN ONE
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IF APPRAISERS DO NOT AGRE
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APPRAISAL
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USED ON DISAGREEMENT ON FIRST PARTY CLAIMS WHERE THE INSURED IS THE CLAIMENT
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ARBITRATION
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A FORM OF DISPUTE RESOLUTION IS BETWEEN THE INSURED AND THE INSURER THE CLAIMANT AND THE INSURES OR BETWEEN THE TWO INSURERS
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MEDATION
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INFORMAL NEGOTIATION WITH A NEUTRAL 3RD PARTY TO DISCUSS THE MATTER
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NEGOTIATION
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FORMAL PROCEDURE TO RESOLVE DIFFERENCES
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CHAPTER 3
answer

CHAPTER 3
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INSURER MEANS
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INSURANCE COMPANY
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INDEPENDENT AGENTS
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REPRESENT MANY COMPANIES
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DIRECT WRITERS OR EXCLUSIVE AGENTS
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–> REPRESENT ONE COMPANY –> DIRECT WRITERS – CAN BE PAID SALARY –> EXCLUSIVE AGENTS- ARE INDEPENDENT BUSINESS PEOPLE AND GET PAID COMMISSION ONLY
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NON-RESIDENT
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IS AN AGENT WHO HAS A TEXAS LICENSE BUT DOES NOT LIVE IN TEXAS THEY GET THE LICENSE TO COLLECT COMMISSION FROM SELLING IN TEXAS
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LIMITED LINES AGENT [CAN ONLY SELL]
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–> JOB PROTECTION INSURANCE –> INSURANCE ON GROWING CROPS –> AUTO INSURANCE FOR MOTOR VEH –> CREDIT INSURANCE
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PERSONAL LINES P&C [CAN SELL]
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–> DWELLING POLICIES –> HOMEOWNERS POLICES –> PERSONAL UMBRELLAS –> PERSONAL AUTO –> FRAUD INSURANCE
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MANAGING GENERAL
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CAN HANDLE THE ADJUSTMENT OF LOSSES OR HIRE OUTSIDE ADJUSTERS TO HANDLE THE LOSSES. THEY DO NOT PAY THEIR LOSSES. THE SURPLUS LINES INSURES (NON- ADMITTED) DO.
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SURPLUS LINES AGENT
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NON-ADMITTED
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MANAGING GENERAL AGENT (MGA)
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REPRESENTS SURPLUS LINES AGENTS (NON-ADMITTED)
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INCLUDES A PERSON FIRM OR CORPORATION THAT HAS SUPERVISORY FOR THE LOCAL AGENCY AND FIELD OPERATIONS OF NON-ADMITTED INSURER IN THIS STATE
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MANAGING GENERAL AGENT (MGA)
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EMERGENCY LICENSES
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NO TEST REQUIRED TEMP LICENSE TO GIVE US TIME TO GET A LICENSE (90 DAYS)
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UNDER WRITERS
answer

ARE NOT LICENSED THEY WORK FOR INSURANCE COMPANIES THEY REVIEW THE INSURANCE APPLICATION TO DECIDE WHETHER OR NOT THE INSURED’S PREMIUM IS ACCEPTABLE AND RISK IS ACCEPTABLE THEN THEY WILL WRITE THE RISK
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QUALIFICATIONS FOR A LICENSE
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NO CONVICTED FELONS ACCEPTED MUST BE 18 YRS OLD TO GET A LICENSE
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LICENSES GOOD FOR 2 YRS
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YOU WILL RECEIVE A 90 DAY NOTICE THAT IS EXPIRING
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TEMP & EMERGENCY LICENSE
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GOOD FOR 90 DAYS
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CONTINUING EDUCATION
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YOUR REQUIRED TO DO 30HRS EVERY TWO YEARS (15HR PER YEAR)
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ONLY LICENSES EXEMPT FROM CONTINUING EDUCATION
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THOSE WHO HAVE HAD A LICENSE FOR MORE THEN 20YRS (MUST FILE FIR THE EXEMPTION )
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A LICENSE MUST MAINTAIN THEIR C.E. RECORDS
answer

BECAUSE THEY ARE REQUIRED TO TAKE 2HR ETHICS CLASSES ( 4 YRS EACH LICENSE RENEWAL CYCLE)[THERE ARE NO CARRY OVERS OF ANY CE CREDITS TO THE NEXT RENEWAL CYCLE]
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GROUND FOR DISCIPLINARY ACTIONS OR DENIALE OF LICENSE
answer

* DENY AN APPLICATION FOR ORIGINAL LICENSE * SUSPEND, REVOKE, DENY RENEWAL OF LICENSE * PUT ON PROBATION WHEN LICENSE IS SUSPENDED *GIVEN A FINE * IF YOU HAVE BEEN CONVICTED OF A FELONY AND YOUR LICENSE IS DENIED OR REVOKED YOU CANNOT REAPPLY FOR FIVE YEARS
question

FIDUCIARIES (US)
answer

ARE PEOPLE YOU TRUST TO TAKE CARE OF YOUR MONEY
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MISREPRESENTING TERMS
answer

INSURANCE POLICY, CONTRACT, COVERAGE.
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CEASE AND DESIST
answer

AN ORDER BY AN ENFORCEMENT AGENCY REQUIRING THE SELLER TO DISCONTINUE A SPECIFIC ACTION THAT MAY VIOLATE THE LAW
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INSURANCE COMMISIONERS
answer

MAY REVOKE OR MODIFY A COMPANIES CERTIFICATE OF AUTHORITY. ( after giving a 10 day notice by certified mail you must appeal within 20 days of board order.)
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THE COMMISSIONER IS ELECTED EVERY __ BY THE VOTES OF THE STATE OF WASHINGTON
answer

4YRS
question

What are the 7 duties of The Commissioner of Insurance?
answer

-Conduct Hearings -Exam financial condition of insurers -Maintain Required Books and Records -Issue Licenses and Certifications of authority to transact insurance business in MT -Issuing Orders and Notices Regarding Insurance Matters -Appointing Individuals to help with the duties of the Insurance Dept -Approve Insurance Forms and Rates
question

washington is a _____ state
answer

prior approval
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LICENSE MAY BE REVOKED OR SUSPENDED IF
answer

*FRAUD APPLYING FOR A LICENSE *MISAPPREHENDED OR CONVERSION OF *COMPANY MONEY OF INSURED’S MONEY FOR THEIR OWN USE *WITH HOLDING MONEY THAT BELONGS TO THE COMPANY, AN INSURED OR BENEFICIARY. AGENTS HAVE A FIDUCIARY RESPONSIBILITY. *MISREPRESENTING TERMS, INSURANCE POLICY, AND CONTRACT COVERAGE *OBTAINING YOUR LICENSE THROUGH FRAUD *REBATING, GIVING GIFTS OR FINANCIAL INDUCEMENT TO HAVE A CUSTOMER BUY A POLICY *DISCRIMINATING, BETWEEN INSURED BASED ON RACE, RELIGION, RELIGIOUS AFFILIATION
question

FIDUCIARIES
answer

ARE PEOPLE YOU TRUST TO TAKE CARE OF YOUR MONEY
question

THE COMMISSIONER MUST GRANT A ___ NOTICE TO LICENSEES PRIOR TO HOLDING ANY HEARING
answer

15 WORKING DAYS
question

COMMISSIONER OF INSURANCE
answer

IS THE CHIEF EXECUTIVE OFFICER OF TEXAS DEPARTMENT OF INSURANCE
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HE/SHE IS NOT A DEPUTY OR DELEGATE
answer

HE/SHE IS THE COMMISSIONER
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MUST BE A US CITIZEN
answer

commisioner
question

COMMISSIONER IS APPOINTED (NOT ELECTED)
answer

BY THE GOVERNOR WITH THE ADVANCE AND CONSENT OF THE SENATE
question

TO BE ELIGIBLE TO BECOME A COMMISSIONER
answer

YOU MUST HAVE 5 YRS EXPERIENCE
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WHEN COMMISSIONER YOU WILL SERVE
answer

2 YR TERM
question

TO BE A COMMISSIONER YOU DO NOT HAVE TO BE
answer

HE/SHE DOES NOT HAVE TO BE AN AGENT OR ADJUSTER
question

DUTIES OF A COMMISSIONER
answer

1) DETERMINE TDI POLICY, ADOPTS RULES AND HEARS APPEALS 2) MAINTAINS FILES OF COMPLAINTS 3) REPORTS VIOLATIONS OF THE LAW TO THE TEXAS ATTORNEY GENERAL OFFICE.
question

A CERTIFICATE OF AUTHORITY
answer

IS A LICENSE TO DO BUSINESS IN THE STATE
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COMMISSIONER CHECKS ON
answer

COMPETENCE, FITNESS, AND REPUTATION OF INSURERS DIRECTORS AND OFFICERS
question

IF A COMMISSIONER REVOKES OR DENIES A CERTIFICATE OF AUTHORITY
answer

YOU HAVE THE RIGHT TO A HEARING IN WHICH YOU MUST APPEAL WITHIN 20 DAYS OF THE BOARD ORDER
question

KNOWINGLY MISREPRESENTING
answer

TO A CLAIMANT, FACTS OR POLICY PROVISIONS (FALLS UNDER UNFAIR CLAIMS)
question

DEFAMATION OF INSURER
answer

DO NOT BAD MOUTH THE COMPETITION, OR DON’T ISSUE STATEMENTS OR THINGS PUBLISH
question

BOYCOTT, COERCION (INTIMIDATE)
answer

DO NOT USE DECEPTIVE ACT
question

TEXAS PROPERTY AND CASUALTY INSURANCE GOVERNMENT ASSOCIATION
answer

PROVIDES FOR THE PAYMENT OF COVERED CLAIMS UNDER CERTAIN INSURANCE
question

TEXAS FAIR PLAN
answer

fair access to insurance requirements plan, an industry placement facility and a joint reinsurance association, is designed to provide fire and extended coverage insurance to individuals who cannot get coverage through regular channels because of increased hazards.
question

TEXAS AUTOMOBILE INSURANCE PLAN ASSOCIATION (TAIPA)
answer

LAST RESORT NO ONE WANTS TO INSURE YOU AT ALL
question

PRIVACY ACT
answer

THE GRAMM, LEACH, BLILEY ACT FINANCIAL SERVICES MODERATION ACT OF 1999 HOW THEIR PRIVATE FINANCIAL INFO SHARED USED (FAIR CREDIT REPORTING ACT (FEDERAL NOT STATE))

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