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New York State Property and Casualty Insurance
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Physical damage coverage under a garage policy is a blanket limit for covered auto, an accurate statement? - ✔✔Yes; The dealer's physical damage limit would be done on a blanket limit basis. This would apply to comprehensive and collision losses to the auto inventory of the dealer. This is done because it is simply not practical to schedule each dealer owned vehicle for physical damage. This is generally accomplished by the use of a monthly reporting form. An insured owns a motorcycle, a moped and a motor home. What endorsement is added to the personal auto policy to provide coverage? - ✔✔Misc. Type Vehicle Endorsement; The "miscellaneous type vehicle" endorsement is added for these types of recreational vehicles. Note that ISO has a separate endorsement for snowmobiles. Investment consultants should purchase which of the following policies to protect themselves from errors and omissions? - ✔✔Professional Liability; Errors and omissions coverage does not involve bodily injury or property damage, which is provided by other types of policies. This is why professional liability coverage is needed. Medical malpractice insurance does cover bodily injury. The negligent act of the agent is imputed to the principal if the act occurred within the course and scope of the agent's employment. This means that the principal becomes: - ✔✔Directly liable for damages to a third party caused by the agent (employee)..This is sometimes referred to as "vicarious" liability. Which of the Homeowner's polices does not include coverage for flood? - ✔✔An HO-3 Policy; A homeowner policy specifically excludes flood coverage. The purpose of a Medicare Supplement policy, (aka Medi Gap), is to: - ✔✔pay for services not covered by Medicare; Medicare coverage contains deductibles and coinsurance payments. Having a Medicare Supplement/Medi Gap policy, offered by commercial insurers, is designed to cover those coverage gaps. Under the Federal Insurance Fraud and False Statements Act, if someone is prohibited from doing business in a state, approval to resume transacting business must be granted by: - ✔✔Insurance Regulatory Official; Only an insurance regulatory official, such as the Insurance Commissioner, can grant permission to resume business.
What is not reflected in a privacy report? - ✔✔Categories of medical information; Medical information is not a topic in a privacy report. It deals with financial issues only. If the surviving spouse of a covered worker does not remarry, how long are death benefits paid to the surviving spouse if the worker is killed in a work related incident in New York? - ✔✔For life; Generally, the surviving spouse receives benefits for the remainder of his or her life, except in situations where they remarry. In situations where the surviving spouse remarries, the spouse receives a lump-sum of two years of benefits. An insured has purchased a Medicare supplement policy from a new insurer, replacing a policy from a previous insurer. A "Notice of Replacement" must be provided to this individual by: - ✔✔The replacing insurer; Since this transaction is a replacement, the insurance regulations of the state require that the replacing insurer must provide the applicant with a Notice of Replacement What mandate is given in the Affordable Care Act requiring all health plans to offer child dependency coverage to age 26? - ✔✔There is no mandate in any federal or state law requiring employer group plans or individual health plans to provide dependent health coverage; None. Health plans are not required by any law to offer dependent care coverage. However, if a group health plan or insurer provides coverage for children, the plan must make such coverage available for a child until age 26. What injury is covered under the medical payments section of an insured's CGL policy? - ✔✔A shopper is injured while visiting a showroom owned by the insured; The coverage excludes injuries to employees, persons participating in an athletic event on the insured's premises and injuries to tenants. The shopper is the only third party that would be covered. Which type of HMO employs its own physicians on a salary basis? - ✔✔Closed Panel; Closed panel plans aka Staff model plans, employ physicians, nurses and other health care professionals. What is an example of a privately run insurers? - ✔✔The excess and surplus lines markets are privately run insurers that usually writes risks that the standard market does not want to write. Which of the dwelling forms provides broad form coverage for personal property? - ✔✔DP-2 and DP- 3 only; The DP-1 provides very limited coverage for personal property. Both the broad form (DP-2) and the special form (DP-3) provide broad form coverage for personal property.
a pipe that has leaked over a period of 14 days; Water damage caused by a pipe that has been leaking beyond 14 days is excluded by this Commercial Property form. The insured owns a 50 HP fishing boat covered under a watercraft policy for hull insurance. He also carries a homeowner policy. He ties his boat to a tree and goes ashore to camp. The next morning he discovers that his boat is stolen. Which policy would pay the claim? - ✔✔The watercraft policy; The watercraft policy would pay the claim. The homeowner policy excludes property more specifically insured and also excludes any boat off the insured's premises for the peril of theft. The medical payments coverage on the farm policy can be claimed for up to: - ✔✔3 years; Similar to a homeowner policy, medical payment claims can be made up to three years from the date of the injury. The deductible under a homeowner policy does not apply to? - ✔✔Liability coverage; Liability coverage as well as medical payments coverage are not subject to a deductible. Commercial Insurance coverage under the broad and special forms covers which of the following types of water damage? - ✔✔A water pipe that bursts; The broad and special cause of loss forms provide coverage for all types of water related damage except that caused by flood, from surface water or water below ground which surfaces. When a homeowners policy has been in effect for 60 days in New York, an insurer can cancel at anytime for any of the following reasons, EXCEPT: - ✔✔A large loss has occurred; The homeowners policy was purchased to indemnify against the occurrence of a large loss, therefore, this would not represent a reason for policy cancellation What are the lifetime dollar limits on the essential benefits provided under ACA? - ✔✔There are no lifetime dollar limits on essential benefits; There is a ban on lifetime dollar limits for most covered benefits for every health plan whether individual plans or group plans. The doctrine of res ispsa loquitur relates to legal liability? Yes or no? - ✔✔In the common law of negligence, the doctrine of res ipsa loquitur (Latin for "the thing speaks for itself") states that the elements of duty of care and breach can be sometimes inferred from the very nature of an accident or other outcome, even without direct evidence of how any defendant behaved.
Which of the following is NOT covered under most commercial crime policies? - ✔✔Legal expenses; The commercial crime policy does not provide legal defense coverage with one exception. Under the forgery or alteration coverage, legal expense coverage is provided. Under Coverage F - Medical Payments of the homeowners program, what is the time limit for expenses to be covered following an accident? - ✔✔3 years; Coverage F refers to medical payments coverage. It pays without regard to the negligence of the insured. All covered expenses up to the specified limit are paid for up to three years. What is the purpose of Umbrella policies? - ✔✔Umbrella policies provide higher limits over primary coverages, provide broader coverage than underlying policies, and they also provide primary insurance in some cases where the underlying policies leave gaps. When the Umbrella policy provides coverage not provided by the underlying coverage there is a SIR (self-insured retention) otherwise considered to be a deductible. Which of the following bonds are used by financial institutions? - ✔✔Standard Form 24 Bond; Standard form #24 is a commonly used financial institution bond used by banks and various financial oriented agencies. The other bonds are fidelity and surety bonds and are used to either guarantee performance of a task or that dishonest acts will not happen. The financial institution bonds are similar to the crime insurance policies used by businesses. The HO-3 policy covers loss to personal property caused by: - ✔✔17 listed perils; With the HO-3 policy, personal property is covered against loss caused by any of the 17 named perils listed in the HO-2 policy. They are (1) fire or lightning; (2) windstorm or hail; (3) explosion; (4) riot or civil commotion; (5) aircraft; (6) vehicles; (7) smoke; (8) vandalism and malicious mischief; (9) theft; (10) breakage of glass; (11) volcanic eruption; (12) freezing of plumbing; (13) accidental discharge or overflow of water from an appliance or plumbing system; (14) weight of ice, snow or sleet; (15) damage from falling objects; (16) sudden and accidental tearing apart of systems or appliances and (17) damage from sudden surges from artificially generated electric current. A common carrier is not held liable for the loss of a shipper's goods when the loss results from: - ✔✔An act of God; They are not responsible for acts of God such as floods, hurricanes or for the negligence of the shipper (poor packing). Premise liability exposure is faced by: 1) Banks 2) Landlords 3) Retail Stores 4) Car Dealers - ✔✔All is correct; All parties/businesses that occupy the covered premises, or have a financial stake in the premises, face liability exposure. The customer is the potential claimant.
end jewelry and watches, the policy provides a maximum theft limit of $2,500 for the entire theft loss. Please keep in mind that these limitations would not apply to losses from the other insured perils. Offering anything of value to a perspective insurance client to induce the client to purchase insurance is called: - ✔✔Rebating; this is considered an illegal act. Under a watercraft policy, which of the following would be covered? 1) Bodily Injury 2) Property Damage
- Medical Payments to Others - ✔✔All is correct; The boat-owners policy includes all. What autos are eligible for coverage under a business auto policy? - ✔✔Basically any type of licensed motor vehicle is eligible for the business auto policy. In the rating of Workers Compensation coverage, a risk that has suffered a frequency of losses may be subject to what is termed "experience modification factors". Which of the following factors would indicate a relatively high surcharge on rates? - ✔✔1.25; A risk that has suffered a frequency of losses will probably have their rates increased. The factor of 1.25 is a relatively high surcharge and indicates a high loss ratio. The circumstances under which a consumer reporting agency may furnish a consumer report include: 1) a credit transaction involving the consumer 2) for employment purposes 3) with the underwriting of insurance - ✔✔All is correct; All of these are circumstances under which an investigative consumer report may be ordered. However, a person may not procure or cause to be prepared an investigative consumer report on any consumer unless it is clearly and accurately disclosed to the consumer that an investigative consumer report may be made. This disclosure must be made in writing and mailed, or otherwise delivered to the consumer, no later than three days after the date on which the report was first requested. An applicant has been advised by his insurer that something adverse appeared on his investigative consumer report. The information is in error. What can the applicant do? - ✔✔Obtain the name of the reporting agency from the insurer and correct the error; The Fair Credit Reporting Act requires consumer reporting agencies to adopt reasonable procedures for meeting the needs of commerce for consumer reports in a manner which is fair and equitable to the consumer with regard to the accuracy of reports. The insurance company is not responsible for correcting consumer report errors. The insurer can advise the applicant of the problem and the name of the reporting agency. It is up to the applicant to have the report corrected
Under the Terrorism Risk Insurance Program Reauthorization Act of 2015, what is the "trigger limit" before claims are paid for the year 2017? - ✔✔$140 million; The trigger was $100 million in 2015, $ million in 2016. The "trigger" will increase by $20 million each year, therefore, it is $140 million in 2017, $160 million in 2018, $180 million in 2019 and $200 million in 2020. To be considered an act of terrorism, there must be at least $5,000,000 in damages caused by terrorism. Before the government pays anything, insurers must absorb the first $120 million in losses. Note: The current Terrorism Risk Insurance Program Reauthorization Act of 2015 is due to expire on December 31, 2020. Are special damages a type of additional coverages under the homeowners program? - ✔✔No; Special damages are the types of compensatory damages an injured party receives for direct and specific expenses involved in a loss. Medical expenses and loss of wages are two examples. These types of damages are addressed by the liability section of the homeowners policy and are not considered "additional coverages." A main street business has suffered an explosion loss from a hot water heating boiler. The civil authorities have blocked off the street and the insured's customers cannot get to his store, causing a loss of income. The insured carries a Businessowners Policy. Before his policy will pay any loss of income there is a _____ waiting period and the policy will then pay for loss of income up to _____. - ✔✔ 72 - hour/four weeks; The policy has a 72-hour waiting period before coverage will pay. It will pay for loss of income for up to four weeks or until the expiration date of the policy. When an insurer cancels a dwelling policy for non-payment of premium, it must give the insured advance notice of at least: - ✔✔10 days; This is standard in the insurance industry except where state variations apply by statute. For example, New York requires a 15 day notice. Which of the following would be considered a personal automobile comprehensive ("other than collision") claim? - ✔✔A load of bricks falling from an apartment building onto the car; A load of bricks falling onto the vehicle would be an "other than collision" loss. This would be considered a "falling objects" claim. The others are considered collision coverage losses. The term "comprehensive" is used in commercial automobile coverage and the term "other than collision" is used in personal automobile coverage to reference the same coverage. What is the purpose of the Buyer's Guide for Medicare recipients? - ✔✔The purpose of the Buyer's Guide is to improve the buyer's ability to select the most appropriate coverage and improve the buyer's understanding of Medicare..
Samantha misses three days from work because of a lawsuit against her, which requires her appearance incourt. She loses $80 in wages each day that she is in court. Her CGL insurance company will pay: - ✔✔$240; the supplemary coverage within GL policy provides wage reimbursment of up to $250 per day The APEX Corporation purchases widgets from the Holly Company. The following statement is on the back of each invoice: "Purchaser shall hold seller harmless from liability arising out of the sale of these widgets." To cover this possible loss exposure, the APEX Corporation should obtain which type of insurance? - ✔✔Commerical General Liability; includes contractual liability coverage for certain defined contracts that are considered to be "insured" contracts. Seldom, if ever, is contractual coverage written by itself. Which of the following would qualify for the Transportation Expense coverage: 1) Car rental fees incurred by the insured due to physical damage to his covered auto. 2) Loss of use expenses for which the insured is liable because of physical damage to his covered auto. - ✔✔Both 1 and 2; Under coverage D, Transportation Expenses are paid at the rate of $20 a day, up to a max of $600. If the vehicle is stolen thre is a 48- hour waiting period. Personal Liability Coverage of the HO program covers the insured for Business Activities. True or False? - ✔✔False; Personal Liability Coverage E provides liability protection for insureds anywhere int he world for their non-business activities. Of course coverage would be subejct to the policy exclusions. If th einsured has to take time off work to help assist in the investigation of the claim, the policy will pay for the actual loss of earnings up to: - ✔✔$250 per day; the most the policy will pay for actual loss earnings is $250 per day if the insured is asked by the comapny to take time off of work to help assist in the investigation and/or defense of the claim. With a Commerical Package Policy, interline endorsements are endorsements that: - ✔✔Could apply to more than one coverage part; More than one line of insurance can be written in the commercial package policy. The purpose of a package policy is to decrease the number of forms. Interline endorsements, such as the common provision form, would apply to all sections of the policy, unless amended. The "last clear chance doctrine" addresses: - ✔✔Avoidance of the occurrence on the part of the plaintiff; the last clear chance doctrine states in essence that if the plaintiff, by his own negligence, places himself in a position of perl from which he cannot ecape and the defendant sees plaintiff in danger or reasonably should have seen the plaintiff in danger, but failed to exercise due care and injured the plaintiff, the defendant is, despite plaintiff's negligence, also at fault.
What does the term "Surplus Lines Company" mean? - ✔✔A non-admitted insurer without a certificate of authority from the state; They are used when an insured cannot obtain coverage in the standard markets. Coverage is placed by surplus lines agent. Which of the following would be covered by the advertising injury coverage under the farm forms? - ✔✔An insured farmer who unknowingly disparaged the crops grown by another farm; The coverage would cover a farmer who unknowingly disparages the crops grown by another farm. Intentional acts, advertising incorrect prices or descriptions are not covered. An employee is asked to operate a piece of machinery known to be in need of repair. The employee refuses and the employer insists that the employee operate the machine or face being laid off the job. The employee uses the machine and is severely injured and loses a limb. His wife sues the employer. What workers compensation coverage might protect the employer? - ✔✔Employer's liability coverage would respond: the purpose is to cover civil suits brought either by the employer or their dependents. The insured carries $100,000 loss of income coverage with a 25% monthy limitation. He sustains a loss of $35,000 for the first month and $20,000 the second month. How much will be paid? - ✔✔$45,000; The polciy will pay $25,000 for the first month and $20,000 for the 2nd month. The total paid would be $45,000. The physical damage coverage for an auto dealer's vehicle held for sale is covered on the garage policy: - ✔✔Blanket basis; The physical damage coverage is provided on a blanket basis since it would be difficult to list each vehicle on the delcarations page. George is named insured under a claims-made CGL policy with a retroactive date of July 1, 2005 and a policy period of Jan 1, 2011 to Jan 1, 2012. The policy was not renewed and allowed to expire. On Feb 10, 2012 a claim made against George for property damage that occured on Dec 31 2005. This claim: - ✔✔Will be covered under the automatic 60-day extendend reporting period if George has no other insurance that applies. In order for a principal- agent rellationship to exist there must be a: - ✔✔A contractual agreement; A principal-agent relationship is created when a fiduciary or legal employment agreement (contract) is made between two parties.
If a large employer has a current Workers Compensation policywith an experience modification factor above 1.00. Is this statement correct? The employer has had a worse-than-expected claims experience during the last few years. - ✔✔An experience modification factor above 1.0 means that the employer's claims record during the experience period (the last four prior years excluding the most recent year) is worse than expected. The insured has an HO-3 policy. During the night, a water line in the wall to the upstairs bathroom burst and water ruined the walls, floor and furniture. In this situation all the damages will be covered, EXCEPT:
- ✔✔Replace the pipe that broke; the policy will not pay for the part of the pipe that broke. All of the other damages are covered. Forcible removal of property from a messenger through the threat of violence is called: - ✔✔Robbery; Robbery must involve a threat of violence or injury. This would include a holdup with a gun or some other form of weapon or other form violence. A tenant leases space in a building. The tenant's space is damaged by fire. When will the Commerical Property policy pay for the damage? - ✔✔When the owner of the building submits proof of loss for the damage "Impaired Property" under the CGL policy is commonly defined as: - ✔✔Tangible property other than "your property" or "your work" that cannot be used, or is less useful, due to your faulty work or your work not completed on time. Telemarketers who transmit prerecorded messages to consumers who have not agreed to accept such messages will be fined up to: - ✔✔$16,00 per call. Sellers and telemarketers who transmit prerecorded messages to consumers who have not agreed in writing to accept such messages will face penalities of up to $16,000 per call. A CGL policy for business has a $600,000 aggregate limit and a $200,000 per occurance limit. The business had one claim for $300,000 and a second claim for $200,000. How much coverage is available if the insurd company has third claim? - ✔✔$200,000; The policy can only pay $200,000 of the $300, claim because of the $200,000 occurrence limit. A second claim can also be covered for $200,000. The two claims that can be paid total $400,000. This subtracted from the $600,000 aggregate limit leaves $200,000 for the rest of the policy period.
What coverage might a self-insured employer purchase to cover Workers Compensation claims that exceeded their plan's pre-established limits? - ✔✔Excess insurance An insurance company can send a notice to the first named insured canceling a business-owner policy for "a large liability loss has occured and the limits are exhausted." - ✔✔True; a large liability is not a legal reason to terminate a policy. Which policy provides a high single limit of protection for catastrophic medical expenses? - ✔✔Major medical expense policy; designed to pay catastrophic expenses, using deductibles and co-insurance limites to control costs (and usage) while providing high max benefits What type of automobile coverage might a person need if he or she does not own a vehicle? - ✔✔A named non-owner auto policy; designed to provide auto coverage for someone who does not own a vehicle but who may need auto coverage when he or she rents a car or borrows a vehicle. It is the same as a personal auto policy except it does not list any specific auto. The mandatory recoupment of the federal share through policyholder surcharges under Terrorism Risk Insurance Program Reauthorization Act of 2015 was increased from 133% to : - ✔✔140%; The TRIA act mandates the government recoup 140% of the difference between the actual amount it has paid and the required retention, up from 133%
