Shared Flashcard Set

Details

Chapter 7
Tx Claims adjuster exam
77
Insurance
Not Applicable
10/22/2015

Additional Insurance Flashcards

 


 

Cards

Term
Mainly, states _______ motorists to carry a policy at their required limits in order to ensure that there is compensation in place in the event that a ______ _______ occurs and there are injuries and/or property damage as a result.
Definition
require, traffic accident
Term
Additionally, it can provide _______ ________ to an insured's assets, liabilities, personal injuries, vehicles, and financial hardship.
Definition
valuable protection
Term
Most commonly, states require drivers to have a _______ policy in order to operate vehicles ________.
Definition
liability, legally
Term
The main intention of requiring at least a liability policy to drive legally is
Definition
to make sure that other motorists will be compensated for injuries and/or damages that are caused by another party, but this benefits the policyholder as well.
Term
By having one of these policies, the insured's provider will pay for _______ and/or ________ that they cause up to the limits purchased. This can be quite __________ considering the cost of medical expenses and the price of repairs or the replacement of vehicles.
Definition
injuries, damages, beneficial
Term
Raising _______ ________ can help pay for serious injuries and damage to property.
Definition
liability limits
Term
If a person suffers a permanent injury, dismemberment or disfigurement, the chances are the the state's requirements ___ ___ ______ in order to cover the cost of medical bills and/or rehabilitation.
Definition
won't be sufficient
Term
There is a standard personal auto policy published by the _______ _________ _________ (___).
Definition
Insurance Services Office (ISO)
Term
Coverage provisions in the ISO personal auto policy are grouped as follows:
Definition
  • definitions coverage's
  • liability coverage's
  • medical payments coverage
  • uninsured motorist coverage
  • first party physical damage
  • insured's duties after accident or loss
  • general provisions
Term
Proprietary personal auto policy forms used by insurer's that do not employ the ISO personal auto policy forms ___ _____ in the ______ in which these ______ of provisions appear.
Definition
may differ, order, categories
Term
Personal auto policies issued in ___-______ states also differ from the _____ personal auto policy.
Definition
no-fault, ISO
Term
As with homeowners policies, the concept of insurable interest
Definition
relates to the coverage's for physical damages to your auto.
Term
A person must have an ______ ________ in the auto in question to be entitled to payment of a loss.
Definition
insurable interest
Term
The easy insurable interest concepts are those of the _______ ________ and a _____ _______, such as your auto loan lender or leasing company of a covered vehicle. However, ________ also extends to non-owned autos.
Definition
registered owner, lien holder, coverage
Term
The common definitions of non-owned autos includes
Definition
rental vehicles and borrowed vehicles as long as they are not regularly available for use by a named insured or a family member.
Term
_________ will generally be considered to have an insurable interest even if not a registered owner of the vehicle.
Definition
Spouses
Term
The concept of insured capacity is mostly a question of
Definition
the definitions of insured, covered person, family member, or eligible injured person, as well as those arising under the vehicles codes and other state laws.
Term
Texas law requires individuals to have
Definition
at least the state limits minimum liability coverage.
Term
The current minimum limits of liability coverage for _____ ______ (___) have are $_______ per person and $_______ per accident.
Definition
Bodily Injury (BI), $30,000; $60,000
Term
The Property damage limit is $_______ per accident.
Definition
$25,000
Term
The current minimum limits of liability coverage for BI and the current property damage limit is also known as _________.
Definition
30/60/25
Term
The other coverage's are ________, but if a person owes money on their car, their bank/lendeer will require them to have _____ coverage which consists of comprehensive and collision coverage.
Definition
optional, full
Term
Bodily Injury
Definition

will pay the other's expenses for accidents caused by drivers covered under your policy, up to your's policy's liabiltiy. These can include:

  • Medical expenses for bodily injury
  • Emergency aid at the scene
  • Medical services for disease or sickness
  • Compensation for loss of income
  • Legal defense fees
  • Funeral expenses
Term

Property Damage

Definition

will pay if another person's property is damaged in an accident that's your fault, _________ ___________ can help pay for:

 

  • Structural damages to homes, storefronts,etc..
  • Vehicle repair or replacement costs
  • Repair or replacement costs for other stationary objects
Term
Liability coverage
Definition
protects you, your family members, and other people driving your car with your permission, even if they don't have their own liability insurance and are not named on your policy.
Term
____ and _____ ______ _______ also are covered when driving someone else's automobile, including a _____ car, but not a car that you don't own but have regular access to, such as a _______ car.
Definition
You, your family members, rental, company
Term
Medical Payments Coverage (Optional)
Definition
Includes medical and funeral bills arising from accidents, including a pedestrian or a bicyclist. It will cover you, your family members, and passengers in your car, regardless of who caused the accident.
Term
Personal Injury Protection (PIP) (Optional)
Definition
Same as medical payments coverage, plus 80 percent of lost income and the cost of hiring a caregiver for an injured person. It covers you, your family members, and passengers in your car, regardless of who caused the accident.
Term
Uninsured Motorist (UM) Coverage (Optional)
Definition
It will pay your expenses from an accident caused by an uninsured motorist or if the other driver did not have enough insurance. It also pays for accidents caused by a hit-and-run driver if you reported the accident promptly to the police.
Term
Underinsured Motorist (UIM) Coverage (Optional)
Definition
This auto coverage provides protection in the event an insured is involved in an accident caused by another who is carrying insurance coverage lower than the amount of the damages and lower than the claimant's Underinsured Motorists coverage.
Term
Bodily injury (UM/UIM)
Definition
covers medical bills, lost wages, pain and suffering, disfigurement, and permanent or partial disability.
Term
Property damage (UM/UIM)
Definition
pays for auto repairs, a rental car, and damage to items carried in your car. There is an automatic $250 deductible. This means you must pay up to $250 of the repairs yourself.
Term
__________/_________ Motorist coverage covers you, your family members, passengers in your car, and other driving your car with your permission. If you don't want ___/______ Motorist insurance, you must _____ it in writing.
Definition
Uninsured/underinsured, UM/UIM, reject
Term
Collision Coverage (Optional)
Definition
Covers the cost of repairing or replacing your car after an accident, regardless of who was driving or who was at fault. Payment is limited to your car's actual cash value, less your deductible. Actual cash value is the market value of a car like yours before its was damaged.
Term
Comprehensive Coverage (Optional)
Definition
Covers the cost of replacing or repairing your car if it is stolen or damaged by fire, vandalism, hail, failing objects or other causes other than collision. Comprehensive coverage also pays for a rental car or other temporary transportation if your car is stolen. Payment is limited to your car's actual cash value, less your deductible.
Term
Towing and Labor Coverage (Optional)
Definition
Will pay for towing charges when your car can't be driven. Also pays labor charges, such as lock-out service, battery jump start and changing a tire, at the place where your car broke down.
Term
Rental Reimbursement Coverage (Optional)
Definition
Pays for a set daily amount for a rental car if your car is stolen or is being repaired because of damaged covered by your policy.
Term
Texas Guaranteed Auto Protection - GAP (Optional)
Definition
Comprehensive and collision coverage only pay up to the actual cash value of the insured vehicle. If you bought your car brand new, there is a strong possibility that your car could depreciate in value more quickly than you are able to pay for it. In these cases, ____ coverage comes to the rescue, paying the difference between the actual cash value of the vehicle and the amount you still owe on the loan.
Term
Driving in other States, Canada, and Mexico
Definition
Your insurance should cover you if you drive in other U.S. states and Canada. Your policy will not cover you in Mexico because Mexico doesn't recognize U.S. auto liability policies.
Term
Mexican authorities may hold drivers _______ and ________ responsible for any auto accidents they cause.
Definition
criminally and financially
Term
Some U.S. insurance companies provide a ____ _________ for your policy that covers occasional trips up to 10 days and up to 25 miles into Mexico.
Definition
free endorsement
Term
These free endorsements _____ ______ meet Mexican legal requirements.
Definition
might not
Term
Some companies sell a Mexico ______ _______ to attach to your Texas policy. This _________ extends your liability coverage to pay costs exceeding a Mexican liability policy's limits. It covers trips of ___ _____ and any _____ ___ ____.
Definition
tourist endorsement, endorsement, any distance, length of time
Term
When you buy an auto policy, your insurance company will send you a _____ -_-_______ card. You must show your current card when you:
Definition

proof-of-insurance

  • are asked for it by a police officier
  • have an accident
  • register your car or renew its registration
  • get or renew your driver's license
  • have your car inspected
Term
The penalties for violating the state's financial responsbility laws are :
Definition
  • First offense: fine of $175 to $350
  • More offenses: fine of $350 to $1,000, suspension of your driver's license, and impoundment of your automobile
  • Offense without a driver's license: $2,000 maximum fine, 180 days in jail, or both
  • Offense if you cause an accident with serious injuries or death: $4,000 maximum fine, one year in jail, or both.
Term
Companies use the __________ process to decide whether to sell a policy and what _____ to charge you. Companies must file their _________ guidelines with ____ and update them each time they make a change.
Definition
underwriting, rate, underwriting, TDI
Term
The factors companies typically use to set premiums include:
Definition
  • Your age, and for younger drivers, your marital status. Men under 25 and unmarried women under 21 have the highest rates. Drivers over 50 may get discounts.
  • Your driving record and claims history. A good driving record can save you money. Insurance companies will charge you more if you have accidents or tickets on your driving record. Companies may also charge more for major convictions, some driving violations, and accidents that damage property. Some surcharges are mandatory and will apply to your premium for three years.
  • Where you keep your car. Rates are typically higher for people who live in cities because they have more accidents and auto thefts than people who live in rural areas.
  • Your car's primary use. Your rates will be higher if you drive your car to and from work or for business. Rates are lowest for people who only drive for pleasure.
  • Your car's type. Collision and comprehensive rates are highest for luxury, high- performance, and sports cars. Rates may also be higher for cars that damage easily or cost more to repair.
  • Your credit score. Companies often use your credit scores to decide if they want to sell you a policy and at what cost. A company can't refuse to sell you a policy or cancel or non-renew your policy based only on your credit.
  • Whether you drove uninsured in Texas. Companies may charge more if you drove uninsured in Texas for more than 30 days in the 12 months before you applied for insurance. If you didn't, a company can't charge you more for liability coverage because of your prior lack of coverage.
Term
Part E of the personal auto policy
Definition
lists the duties of an insured following an accident or loss.
Term
The insured following an accident or loss must:
Definition
  • cooperate with the insurer in the investigation, settlement, or defense of any claim
  • provide the insurer and police information regarding a hit-and-run driver
  • protect the damaged property from further damage in the event of a damage to your auto coverage loss
  • notify the police promptly if the auto is stolen
  • notify the company promptly and permit the insurer to inspect and appraise the damaged property before it is repaired or replaced.
Term
Inception of coverage
Definition
Coverage begins at 12:01 am on the inception date.
Term
Territory
Definition
Coverage applies only to losses, accidents, occurences that take place during the policy period and within the United Staes, its territories and possessions, Puerto Rico, or Canada, or while being transported between the ports in any of those places.
Term
Action against the company
Definition

An insured agrees not to sue the insurance company to provide coverage until :

  • he has complied fully with all terms of the policy
  • the obligation to pay has been determined by judgment after trial or the insurer agrees in writing tha the insured has an obligation to pay
Term
Bankruptcy
Definition
The insured's bankruptcy or insolvency does not relieve the insurance company of its obligation.
Term
Fraud
Definition
The Personal Auto Policy provides no coverage for an insured who has made fraudulent statements or engaged in fraudulent conduct.
Term
Subrogation
Definition
The insurer has subrogation rights under all coverage's of the Personal Auto Policy except under Coverage D (Collision) against a person using a covered auto with a reasonable belief that he or she is entitled to do so. The insured must reimburse or hold in trust for the insurer any recovered damages the insured collects after the insurer has made payment.
Term
Policy changes
Definition
A written endorsement by the insurer that forms part of the policy is the only way to change the policy. Premiums are computed from the effective date of the change. If the insurer changes its Personal Auto Policy to provide more coverage, without additional premium, or if a statue requires a change in coverage, any PAP policy already issued provides the additional coverage.
Term
Assignment
Definition
The PAP (Personal Auto Policy) may not be assigned without the insurer's consent. However, if a named insured dies, coverage will be provided for the surviving spouse if a resident of the same household at the time of death, or the legal representative of the deceased person to maintain or use a covered auto. This coverage is provided only until the end of the policy period.
Term
Termination
Definition
  1. Non- renewal- The company may non-renew the policy by providing the named insured with 20 days written notice. State regulations may modify the requirements by restricting the notice or grounds.
  2. Cancellation- During the policy period, the insured may cancel the policy by giving advanced written notice.
  • If the insurer cancels the policy, it must provide 10 days written notice when the cancellation is made for nonpayment of premium or during the first 60 days of a new policy for almost any underwriting reason.
  • The insurer must give 20 days written notice when the policy has been in effect for 60 days; if it is a renewal or continuation policy, and cancellation occurs because the driver's license of the insured, someone who lives with the insured, or someone who normally drives the insured's auto is revoked or suspended during the policy period or since the last annversary of the effective date; or the policy was obtained through material misrepresentation.
  • State regulations may modify the notice requirements.
Term
Auto insurance premiums are based on several criteria, including:
Definition
  • the type and amount of coverage desired
  • the individuals who will operate the auto
  • where the vehicle is garaged
  • the deductible amount
  • the make and model of the auto
  • the use of the auto
  • number of miles driven
  • age and sex etc...
Term
The ________ ________ depends on several provisions that ____ the methods for paying automobile insurance claims.
Definition
claims department, direct
Term
Aftermarket parts regulation
Definition
Insurance companies cannot require repairs at specific repair facilities or require that parts other than window glass be replaced with parts other than original equipment parts.
Term
Auto repair claims settlement
Definition

Auto claims are settled at Actual Cash Value, and the insurer will :

  • total the vehicle when the repair costs exceeds the value of the vehicle ( the insured is paid the value of the vehicle and the insurer retains the vehicle for salvage)
  • repair the vehicle when the repair cost is less than the value of the vehicle ( the insurer pays all costs necessary to repair the damage )
  • replace the vehicle when the insurer can find another vehicle of like kind and quality and offer it to the insured as a replacement vehicle
Term
Arbitration
Definition
This settlement option between the insured and the insurer is used to resolve any disagreement except those regarding the value of a loss.
Term
Appraisal
Definition
This settlement outlines a procedure to be used when the insured and the insurer disagree on the amount of a loss. Each selects an appraiser, and the two appraisers then select an umpire. If the appraisers cannot agree, the umpire is consulted. An amount agreed to by two out of the three is the amount paid for the loss.
Term
Automobile Insurance Plans
Definition

Also known as assigned risk plans, these are the oldest type of residual (shared) market plans. They provide auto coverage for drivers who are unable to obtain coverage in the normal or standard market, for example:

  1. When a driver is refused coverage in the standard market ( because he is a high-risk driver), he may apply to the state's automobile insurance plan.
  2. The plan is a pool made up of all licensed auto insurers in the state. The application made by a driver is assigned to one of the members (insurers) of the plan.
  3. A notice of eligibility in the assigned risk pool must be provided to the insured if an automobile liability policy is non-renewed or canceled for other than non payment of premium. This notice is a state notifying the insured that he may be eligble for liability insurance through the assigned risk plan.

 

Term
Coverage for autos used primarily for business purposes may be added to the _______ ________ _________.
Definition
commercial package policy
Term
Business Auto Coverage Form
Definition
this form covers vehicles used to conduct business. It does not cover vehicles that are sold, stored, or repaired for clients.
Term
Types of covered autos
Definition
This coverage includes trucks, auto, trailers, and buses.
Term
Mobile equipment
Definition
Not included in this policy are off-road vehicles called mobile equipment, such as bulldozers, forklifts, cherry pickers, and backhoes. These are insured for physical damage by a property floater, and for bodily injury by a commercial general liability policy. Liability extends from the power unit while the mobile equipment is hauled or towed.
Term
Covered persons
Definition
Covered persons include the named insured and anyone (with permission) using the auto.
Term
Coverage provided
Definition
Bodily injury and property damage liability coverage are provided up to the limits of the policy. Physical damage coverage is also available (comprehensive and collison) subject to a deductible.
Term
Many of the exclusions, definitions, conditions, rating information, and supplementary payments provided under the business auto policy (commercial auto)
Definition
are similar to those found in the personal auto policy (PAP).
Term
Garage Coverage Form
Definition
This type of liability insurance is basically a package of coverages sutied for automobile dealers. It consits of premises and operations coverages, contractual liability coverage for insured contracts, products and completed operations coverages, premises medical payments insurance, dealers physical damage, and some auto liability coverage depending upon the nature of the operation.
Term
Premises and operations coverages (garage liability)
Definition

The premises and operations coverage of a garage liability policy is very similar to coverage provided under commercial general liabiltiy.

  1. These coverages apply when bodily injury or property damage arises out of garage operations. Garage operations include the ownership, maintenacne, or use of the premises for purposes of a garage and all operations necessary or incidental to it.
  2. Premises is defined as the premises where the named insured conducts garage operations including the areas immediately adjoining. For example, if a dealer decides to sell household appliances, these operations are not likely to be considered necessary or incidental to the operation of the business and would not be covered by this contract.
Term
Dealers physical damage
Definition
Damage to the autos of an automobile dealer may be covered under this section of coverage, including autos used in the operation of the business or those being held for sale.
Term
Exclusions
Definition
Most exclusions are similar to those that apply under a commercial general liability policy, such as damage to property in the care, custody, and control of the insured. However, liability assumed by insured contracts are covered.
Term
Garagekeepers coverage
Definition

Garagekeepers insurance is a type of bailee coverage (protecting the business for damage to the property of their customers) available to automobile dealerships. Garagekeepers insurance provides coverage for damage to automobiles of others arising out of the general operation of business.

  1. The need for garagekeepers insurance arises from the fact that garage liability insurane does not cover property damage losses to automobiles in an insured's care, custody, or control.
  2. Specified peril coverage is available. Examples include fire, explosion, theft, and vandalism. Comprehensive and collision coverage are also available. All are subject to a deductible.
  3. Losses not covered- The garagekeepers policy does not cover losses caused by:
  • theft by an insider (by the named insured, employees, or shareholders)
  • contractual liability
  • products or work loss
  • sound reproducing or receiving equipment, unless permanently installed in the auto
  • other losses not covered such as those caused by war, rebellion, racing, and so forth.
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