- What is insurable interest?
- A financial relationship to the insured property or person such that a loss causes the insured genuine harm. In property/casualty it must exist at the TIME OF LOSS.
- When must insurable interest exist in P&C?
- At the TIME OF LOSS (in life insurance, only at the time of application). This timing distinction is heavily tested.
- What is the principle of indemnity?
- Restoring the insured to the same financial position as just before a loss — no profit, no penalty. P&C policies are indemnity contracts.
- What is subrogation?
- The insurer's right, after paying a covered claim, to recover that amount from the third party who actually caused the loss. It enforces indemnity and prevents a double recovery.
- Can an insured impair the insurer's subrogation right?
- No. If the insured releases the at-fault party before being paid, they can destroy the insurer's recovery right and jeopardize their own claim.
- What is a peril?
- The actual CAUSE of a loss — fire, windstorm, theft, collision, hail, vandalism.
- What is a hazard?
- A CONDITION that increases the chance or severity of a loss. Types: physical, moral, morale, and legal.
- What is a physical hazard?
- A tangible condition that increases the chance of loss — icy steps, worn wiring, oily rags by a furnace.
- What is a moral hazard?
- A DISHONEST tendency or intent to cause or exaggerate a loss — e.g., deliberately burning insured property. (Contrast morale = carelessness.)
- What is a morale hazard?
- Carelessness or indifference to loss because insurance exists — e.g., leaving keys in an unlocked car. (Contrast moral = dishonest intent.)
- Memory hook: moral vs morale hazard?
- Moral = dishonest intent (fraud). Morale = careless indifference (laziness). The one extra 'e' flips it from fraud to laziness.
- What is pure risk?
- A risk involving only the chance of loss or no loss, with no chance of gain. It is the ONLY insurable type of risk.
- What is speculative risk?
- A risk with a chance of loss, no loss, OR gain (gambling, investing). It is NOT insurable.
- What is the law of large numbers?
- As the number of similar, independent exposure units grows, actual losses come closer to predicted losses — the statistical basis that makes insurance possible.
- What is adverse selection?
- The tendency of higher-risk individuals to seek or keep insurance more than lower-risk ones, threatening loss predictions. Underwriting combats it.
- What are the five risk-management techniques?
- Avoidance, Retention, Reduction (loss control), Sharing, and Transfer. Insurance is the chief risk-TRANSFER device.
- What is risk avoidance?
- Eliminating the risk entirely — the only method that reduces the chance of loss to zero (e.g., never building on a floodplain).
- What is risk retention?
- Keeping the risk and paying losses yourself — planned (a high deductible, self-insurance) or unplanned.
- What is reinsurance?
- Insurance bought by an insurer (the cedant) to transfer part of its risk to a reinsurer — letting it write larger books and limit catastrophe accumulation.
- Treaty vs facultative reinsurance?
- Treaty = an automatic, portfolio-level agreement. Facultative = negotiated risk by risk.
- What are the four elements of a valid contract?
- Offer and acceptance, consideration, competent parties, and a legal purpose.
- What does 'aleatory' mean for an insurance contract?
- The parties exchange UNEQUAL amounts depending on an uncertain event — an insured may pay little and collect much, or vice versa.
- What is a contract of adhesion?
- A 'take it or leave it' contract drafted entirely by one party (the insurer). Ambiguities are construed against the drafter — in favor of the insured.
- What does 'conditional' mean for an insurance contract?
- The insurer's duty to pay is subject to conditions the insured must first meet (notice, proof of loss, cooperation).
- What does 'unilateral' mean for an insurance contract?
- Only ONE party — the insurer — makes a legally enforceable promise. Only the insurer can be sued for breach.
- What does 'personal' mean for an insurance contract?
- The contract is between the insurer and a specific person; selling the property doesn't transfer the policy without the insurer's consent.
- What are the five characteristics of an insurance contract?
- Aleatory, Adhesion, Conditional, Unilateral, and Personal.
- What is utmost good faith?
- The duty (uberrimae fidei) of both parties to deal honestly and disclose all material facts — a higher standard than ordinary contracts.
- What is a representation?
- A statement believed true, made on the application. It must be substantially true; only a MATERIAL misstatement matters.
- What is a warranty (in contract law)?
- A statement guaranteed true and made part of the contract — a stricter standard than a representation.
- What is concealment?
- Failure to disclose a known MATERIAL fact (silence/omission). If intentional and material, the insurer may void coverage.
- What is misrepresentation (contract law)?
- A false statement of a material fact (an active falsehood). If material, the insurer may rescind or void the policy.
- Representation vs warranty?
- Representation = believed true. Warranty = guaranteed true (stricter).
- Concealment vs misrepresentation?
- Concealment = what you DIDN'T say (silence). Misrepresentation = what you said FALSELY (active).
- What is waiver?
- The voluntary surrender of a known legal right.
- What is estoppel?
- Being barred from asserting a right because someone relied on your prior conduct.
- What does DICE stand for?
- Declarations, Insuring agreement, Conditions, Exclusions — the four core parts of a P&C policy (plus Definitions and Endorsements).
- What are the Declarations?
- The fact page: WHO is the named insured, WHAT property/risk is covered, the policy period, limits, deductibles, and premium. The 'D' in DICE.
- What is the Insuring Agreement?
- The insurer's core promise to pay for covered losses — the heart of the policy. The 'I' in DICE. Written as named-peril or open-peril.
- What are policy Conditions?
- The rules and duties of both parties: notice of loss, proof of loss, cooperation, cancellation, appraisal, and subrogation. The 'C' in DICE.
- What is an Exclusion?
- A policy provision stating what is NOT covered — it narrows the insuring agreement (e.g., flood, earth movement, war, intentional acts). The 'E' in DICE.
- What is an endorsement (rider)?
- An attachment that adds, deletes, or modifies policy provisions — e.g., a replacement-cost or scheduled-property endorsement.
- What is a binder?
- A temporary contract providing immediate, unconditional coverage before the policy is issued — common in P&C.
- What is a deductible?
- The amount the insured pays out of pocket before insurance applies. A higher deductible lowers the premium.
- What is the difference between a peril and a hazard?
- A peril is the CAUSE of a loss (fire, theft); a hazard is a CONDITION that makes that loss more likely or severe.
- What is a stock insurer?
- An insurer owned by shareholders that issues nonparticipating policies (no policyowner dividends).
- What is a mutual insurer?
- An insurer owned by its policyowners that may issue participating (dividend-paying) policies.
- Admitted vs non-admitted insurer?
- Admitted = state-licensed and backed by the guaranty fund. Non-admitted (surplus lines) = not licensed in the state; used for hard-to-place risks.
- What is underwriting?
- The process of evaluating, classifying, and pricing risks to decide whether and how to insure an applicant. It guards against adverse selection.
- What is a proximate cause (coverage)?
- The primary, efficient cause that sets in motion an unbroken chain of events leading to a loss.
- Named-peril coverage?
- Pays only for losses caused by perils specifically LISTED. The INSURED must prove the loss was a listed peril. Narrower, cheaper.
- Open-peril coverage?
- 'All-risk'/special — pays for all causes of loss EXCEPT those excluded. The INSURER must prove an exclusion applies. Broader, costlier.
- Named-peril vs open-peril — what really differs?
- The burden of proof. Named-peril: the insured proves coverage. Open-peril: the insurer proves the exclusion.
- What is the HO-1 form?
- The Basic homeowners form — covers a minimal list of named perils. Largely obsolete today.
- What is the HO-2 form?
- The Broad form — named-peril coverage on BOTH the dwelling and personal property for an owner-occupant.
- What is the HO-3 form?
- The Special Form — the MOST COMMON. Open-peril on the dwelling, named-peril on personal property. 'Open on the house, named on your stuff.'
- What is the HO-4 form?
- The renters/tenants form. Covers personal property and liability but NO dwelling, because the tenant doesn't own the building.
- What is the HO-5 form?
- The Comprehensive form — the broadest standard homeowners policy. Open-peril on BOTH the dwelling and personal property.
- What is the HO-6 form?
- The condominium unit-owner form. Covers interior improvements and personal property; the association master policy covers the exterior.
- What is the HO-8 form?
- The modified form for older homes whose replacement cost exceeds market value — typically a functional/ACV settlement.
- Which HO form covers open-peril on BOTH dwelling and contents?
- The HO-5 (Comprehensive). The HO-3 is open on the dwelling but named on contents.
- What is HO Coverage A?
- Dwelling — the house plus attached structures. The base limit; B, C, and D are percentages of Coverage A.
- What is HO Coverage B and its usual limit?
- Other Structures (detached garage, fence, shed) — usually 10% of Coverage A.
- What is HO Coverage C and its usual limit?
- Personal Property (your belongings) — usually 50% of Coverage A (often raisable to 70%).
- What is HO Coverage D and its usual limit?
- Loss of Use / Additional Living Expense — usually 30% of Coverage A.
- What is HO Coverage E?
- Personal Liability — pays bodily injury and property damage you're legally liable for, plus defense costs. A flat limit (e.g., $100,000).
- What is HO Coverage F?
- Medical Payments to Others — pays others' medical bills regardless of fault (a small goodwill coverage). A flat limit.
- Exam trap: are B, C, and D percentages of each other?
- No. B, C, and D are all percentages of Coverage A — never of each other. Memorize 10 / 50 / 30.
- What is a Dwelling (DP) policy used for?
- Properties not eligible for a full homeowners policy — rentals, seasonal cabins, vacant or older homes. No automatic liability or contents.
- DP-1 form?
- Basic dwelling form — named-peril (~9 perils), settled at ACV. Cheapest; older or vacant homes.
- DP-2 form?
- Broad dwelling form — named-peril (broader list), settled at replacement cost.
- DP-3 form?
- Special dwelling form — open-peril on the dwelling, replacement cost on the structure. The broadest/most common for rentals.
- Which DP forms are named vs open peril?
- DP-1 and DP-2 are named-peril; DP-3 is open-peril. DP-1 settles at ACV; DP-2 and DP-3 at replacement cost.
- What is a Businessowners Policy (BOP)?
- A pre-packaged bundle of commercial property + general liability for small/mid eligible businesses; often written without a coinsurance penalty.
- What is a Commercial Package Policy (CPP)?
- A modular policy combining two or more standalone coverage parts under one declarations page, for larger businesses needing higher limits.
- What are the commercial causes-of-loss forms?
- Basic, Broad, and Special, attached to a commercial property form. Special is open-peril (broadest); basic and broad are named-peril.
- What is Actual Cash Value (ACV)?
- Replacement cost MINUS depreciation — the depreciated value of property at the time of loss. ACV pays less on older, worn property.
- What is replacement cost?
- The cost to repair or replace property with like kind and quality, with NO deduction for depreciation.
- How does the standard HO-3 settle dwelling vs contents?
- Dwelling at replacement cost; personal property at ACV — unless a replacement-cost endorsement is added on contents.
- What is a coinsurance clause?
- It requires the insured to carry insurance equal to a stated % of value (often 80/90/100%); carrying less makes them a co-insurer of a partial loss.
- What is the coinsurance formula?
- Payment = (Did / Should) x Loss - Deductible, where Should = coinsurance % x value, and Did = the amount carried.
- When does the coinsurance penalty apply?
- Only to PARTIAL losses. A total loss simply pays the policy limit — coinsurance is ignored.
- What is an Agreed Value endorsement?
- An endorsement that suspends the coinsurance clause because the insurer and insured agree on the property's value in advance.
- Coinsurance example: 80% on a $500,000 building, $300,000 carried — what fraction is paid?
- Should = 80% x $500,000 = $400,000. Did / Should = $300,000 / $400,000 = 0.75. A partial loss is paid at 75% (minus deductible).
- What is a valued policy?
- A policy that pays a pre-agreed amount on a total loss, rather than ACV or replacement cost.
- What is functional replacement cost?
- Rebuilding with modern, less costly equivalents (common on HO-8) when full replacement cost would exceed market value.
- Is flood covered by a standard property policy?
- No — flood is EXCLUDED. It is bought separately, usually through the National Flood Insurance Program (NFIP), administered by FEMA.
- Is earthquake covered by a standard HO policy?
- No — earthquake is excluded. It is added by endorsement or a separate policy.
- What are NFIP residential coverage limits?
- Up to $250,000 on the building and up to $100,000 on contents; a new policy generally has a 30-day waiting period.
- What is a floater?
- Inland marine coverage that travels WITH movable property (jewelry, fine art, instruments) — usually open-peril and often worldwide.
- What is business income (business interruption) coverage?
- Pays lost income (and extra operating cost via extra expense) while operations are suspended by a covered property loss.
- What is equipment breakdown (boiler & machinery) coverage?
- Covers sudden, accidental breakdown of boilers, pressure vessels, and electrical equipment.
- Why is HO-8 settled on a modified basis?
- Because older homes' replacement cost can far exceed market value; HO-8 pays a functional/ACV settlement to avoid over-insuring.
- Section I vs Section II of an HO policy?
- Section I = Property (Coverages A-D). Section II = Liability (Coverages E-F).
- Which HO form fits a tenant who owns no building?
- The HO-4 (renters form) — personal property and liability, no dwelling coverage.
- What is a tort?
- A civil wrong (other than breach of contract) that causes injury, remedied by damages.
- What is negligence?
- Failure to use the care a reasonably prudent person would. It requires four elements: duty, breach, proximate cause, and damages.
- What are the four elements of negligence?
- Duty owed, breach of that duty, proximate cause, and actual damages. Missing any one defeats the claim.
- What is 'duty' in a negligence claim?
- A legal obligation to act with reasonable care toward another person.
- What is 'breach' in a negligence claim?
- Failing to meet the reasonable-care standard (e.g., mopping a floor but posting no warning sign).
- What is an intervening (superseding) cause?
- A new, independent cause that breaks the chain of proximate cause and can defeat liability.
- What is contributory negligence?
- A strict rule (only a few states: AL, MD, NC, VA, DC) that bars all recovery if the plaintiff was even slightly at fault.
- What is pure comparative negligence?
- Recovery is reduced by the plaintiff's percentage of fault — they can recover even if 99% at fault.
- What is modified comparative negligence?
- The plaintiff recovers only if their fault is below a 50%/51% threshold; recovery is barred at or above it.
- What is assumption of risk?
- A defense: the plaintiff knowingly accepted a known danger, barring recovery within the assumed risk.
- What is strict (absolute) liability?
- Liability imposed WITHOUT proving fault — for ultra-hazardous activities (blasting, wild animals) and defective products.
- What is vicarious liability?
- Liability of one party for another's acts based on their relationship (employer/employee, parent/child), regardless of the held party's own care.
- What is respondeat superior?
- The employer-for-employee form of vicarious liability — an employer is liable for an employee's acts within the scope of employment.
- What are compensatory damages?
- Damages that reimburse the injured party for actual loss — special (measurable) and general (intangible).
- Special vs general compensatory damages?
- Special = measurable economic loss (medical bills, lost wages). General = intangible loss (pain & suffering, loss of consortium).
- What are punitive (exemplary) damages?
- Damages that punish reckless or willful conduct and deter others. Often excluded or uninsurable as a matter of public policy.
- Which damages do liability policies pay?
- Compensatory damages. Punitive damages are often excluded or uninsurable by law.
- What is a per-occurrence limit?
- The most the insurer pays for any single accident/occurrence (e.g., $1,000,000 per occurrence).
- What is an aggregate limit?
- The most the insurer pays for ALL losses in the policy period (e.g., $2,000,000 aggregate).
- What are split limits?
- Three separate liability limits: BI per person / BI per accident / PD per accident (e.g., 100/300/50).
- What is a Combined Single Limit (CSL)?
- One liability limit covering bodily injury and property damage combined, per accident, in any mix.
- What is a CGL policy?
- Commercial General Liability — the core business-liability coverage for bodily injury, property damage, and personal & advertising injury.
- What does CGL Coverage A cover?
- Bodily Injury & Property Damage liability from an occurrence — premises/operations and products/completed operations; includes defense.
- What does CGL Coverage B cover?
- Personal & Advertising Injury — libel, slander, defamation, false arrest, wrongful eviction, advertising/copyright infringement.
- What does CGL Coverage C cover?
- Medical Payments — others' medical expenses regardless of fault (no-fault goodwill coverage).
- What is an occurrence trigger?
- Covers injury/damage that HAPPENS during the policy period, no matter when the claim is filed — even years later.
- What is a claims-made trigger?
- Covers only claims first MADE during the policy period, subject to a retroactive date; may need an Extended Reporting Period (a 'tail').
- What is a retroactive date?
- On a claims-made policy, the date before which injuries are NOT covered, even if the claim is made during the policy period.
- What is an Extended Reporting Period (tail)?
- An extension on a claims-made policy that extends the time to REPORT a claim for past work — it does not cover new occurrences.
- Occurrence vs claims-made premium?
- Occurrence costs more (simpler, covers late claims). Claims-made starts cheaper and rises as it 'matures.'
- What is workers' compensation?
- A statutory, no-fault system: an injured employee gets benefits regardless of fault and, in exchange, gives up the right to sue the employer.
- What is the exclusive remedy doctrine?
- The workers' comp bargain ('grand bargain'): the employee gets no-fault statutory benefits and gives up the right to sue the employer.
- What does Workers' Comp Coverage Part One do?
- Pays all benefits the state WC law requires — with NO dollar limit (statutory benefits).
- What does Workers' Comp Coverage Part Two do?
- Employers Liability — covers work-injury suits OUTSIDE the WC statute, and HAS limits.
- What does Workers' Comp Coverage Part Three do?
- Other States Insurance — extends coverage to listed states the employer might expand into.
- What benefits does workers' comp provide?
- Medical care, a portion of lost wages, death benefits, and rehabilitation.
- What is an umbrella policy?
- Excess liability above primary policies (CGL, auto, employers liability) that adds limits, drops down when an underlying aggregate is exhausted, and can broaden coverage.
- Umbrella vs excess policy?
- An umbrella adds limits AND can broaden coverage (subject to a self-insured retention). A plain excess policy adds limits only.
- What is a self-insured retention (SIR)?
- An amount the insured pays out of pocket before an umbrella responds to a gap not covered by an underlying policy.
- What is E&O insurance?
- Errors & Omissions (professional liability) — covers service errors, faulty advice, or negligence by a professional. Usually claims-made.
- What is D&O insurance?
- Directors & Officers liability — covers corporate directors and officers (and often the entity) for wrongful acts in their management decisions.
- What is EPLI?
- Employment Practices Liability Insurance — covers employment claims such as wrongful termination, discrimination, and harassment.
- What is the 'Who Is An Insured' provision?
- The part of a liability policy that defines, beyond the named insured, which additional persons and organizations qualify for coverage.
- What are supplementary payments?
- Amounts a liability insurer pays IN ADDITION to the limit — such as defense costs, bonds, and court costs.
- Are defense costs inside or outside the CGL limit?
- Outside — defense costs are a supplementary payment paid in addition to the policy limit.
- How many parts are in the Personal Auto Policy (PAP)?
- Four: Part A Liability, Part B Medical Payments, Part C UM/UIM, Part D Damage to Your Auto.
- What does PAP Part A cover?
- Liability (BI/PD) — damages you're legally liable to others for. Defense is paid IN ADDITION to the limit.
- What does PAP Part B cover?
- Medical Payments — reasonable medical/funeral expenses regardless of fault, incurred within 3 years.
- What does PAP Part C cover?
- Uninsured/Underinsured Motorist (UM/UIM) — your bodily injury from an at-fault driver with no or insufficient insurance, or a hit-and-run.
- What does PAP Part D cover?
- Damage to Your Auto — first-party physical damage: Collision and Other-Than-Collision, minus a deductible.
- What is UM coverage?
- Uninsured Motorist — pays your bodily injury when the at-fault driver has NO insurance, is a hit-and-run, or is insolvent.
- What is UIM coverage?
- Underinsured Motorist — pays when the at-fault driver has insurance but NOT ENOUGH to cover your injuries; it pays the gap.
- UM vs UIM?
- UM = the at-fault driver has NO insurance. UIM = they have insurance but NOT ENOUGH.
- What does auto Collision coverage cover?
- Your vehicle's upset, rollover, or striking another object (another car, a tree, a pole, a guardrail).
- What does auto Comprehensive (other-than-collision) cover?
- Non-collision losses — fire, theft, hail, flood, vandalism, falling objects, glass breakage, and hitting an animal.
- Is hitting a deer collision or comprehensive?
- Comprehensive (other-than-collision), NOT collision. The classic auto exam trap.
- Is glass breakage collision or comprehensive?
- Comprehensive (other-than-collision).
- What do split limits like 25/50/25 mean?
- $25K bodily injury per person / $50K BI per accident / $25K property damage per accident.
- What is no-fault (PIP) auto insurance?
- In no-fault states, your own insurer pays your medical and lost wages through Personal Injury Protection (PIP) regardless of fault, and your right to sue is limited by a threshold.
- PIP vs Medical Payments?
- PIP (no-fault states) is broader — it covers medical, lost wages, and related expenses. Medical Payments covers medical/funeral expenses only.
- What is a financial responsibility law?
- Requires proof of the ability to pay AFTER an accident or violation (via insurance, a bond, or a deposit).
- What is a compulsory insurance law?
- Requires a driver to carry liability insurance UP FRONT.
- What is an SR-22?
- A certificate the INSURER files verifying minimum coverage (not a policy itself); often required after a DUI.
- What is an FR-44?
- A higher-limit version of the SR-22 — used in Florida and Virginia only.
- What is the Business Auto Policy (BAP)?
- Commercial auto coverage that uses covered-auto SYMBOLS (not a vehicle schedule) to say which autos a coverage applies to.
- What is BAP Symbol 1?
- 'Any auto' — the broadest covered-auto designation; it closes every gap, including temporary substitute vehicles.
- BAP trap: do symbols 2 + 8 + 9 equal symbol 1?
- No. Only Symbol 1 ('any auto') truly closes every gap. 2+8+9 do NOT equal 1.
- What is the Garage Coverage Form for?
- Auto dealerships and similar auto businesses — it blends liability and physical damage and includes garage operations.
- What is Garagekeepers coverage?
- Protects a garage, repair shop, or storage operation against liability for damage to CUSTOMERS' autos left in its care, custody, or control.
- Who is a 'covered person' for PAP liability?
- The named insured and family members, anyone using the covered auto with permission, and others liable for that use.
- What is inland marine insurance?
- Coverage for movable property, property in transit, and high-value scheduled items (jewelry, fine art) — usually open-peril.
- What does ocean marine insurance cover?
- Hull, Cargo, Freight, and Protection & Indemnity (liability) for vessels and their cargo.
- What is crime insurance?
- Covers loss of money/securities from employee dishonesty, theft, robbery, burglary, and forgery.
- What is a fidelity bond?
- Reimburses an EMPLOYER if an employee steals money or property. A two-party arrangement (employer + insurer).
- What is a surety (performance) bond?
- A three-party guarantee that a contractor (principal) will COMPLETE the job per the contract for the project owner (obligee).
- Fidelity vs surety bond?
- Fidelity = two-party, reimburses an employer for employee theft. Surety = three-party, guarantees a contractor completes the job.
- Who are the three parties to a surety bond?
- The principal (who must perform), the obligee (who is protected), and the surety (who guarantees performance).
- Is a surety bond insurance?
- No — it is a three-party guarantee of performance, not a two-party indemnity insurance contract.
- What is a FAIR plan?
- A residual-market mechanism providing basic PROPERTY coverage to applicants who can't obtain it in the standard market.
- What is an automobile assigned-risk (shared market) plan?
- A residual-market mechanism making AUTO coverage available to high-risk drivers who can't obtain it normally.
- What is cyber liability insurance?
- Covers a business's data-breach and cyber-incident liability, including notification and recovery costs.
- What is loss assessment coverage?
- An HO endorsement that pays a condo/co-op unit-owner's proportionate share of an assessment levied by the association for a covered loss.
- What does a personal umbrella policy do?
- Provides high excess liability limits above an insured's underlying auto and homeowners coverage and can fill some coverage gaps.
- What is a residual (shared) market?
- Mechanisms that provide coverage to risks the voluntary market won't write — FAIR plans (property) and assigned-risk plans (auto).
- What is an inland marine floater?
- A schedule of specific high-value movable items (jewelry, cameras, instruments) covered usually open-peril and often worldwide.
- What is a producer?
- A person licensed to sell, solicit, or negotiate insurance. The NAIC Producer Licensing Model Act merged 'agent' and 'broker' into 'producer.'
- Whom does an agent represent?
- The INSURER — and an agent can typically bind coverage.
- Whom does a broker represent?
- The APPLICANT/client — and a broker generally cannot bind coverage.
- What is express authority?
- Authority explicitly granted in writing in the agent's contract or appointment (e.g., authority to bind auto up to a stated limit).
- What is implied authority?
- Authority not written but reasonably necessary to carry out express authority (e.g., renting an office, collecting premiums).
- What is apparent (ostensible) authority?
- Authority the public reasonably believes an agent has based on the insurer's conduct, even where no actual authority was granted.
- What is a producer's fiduciary duty?
- Producers hold client premiums in trust; commingling client funds with their own personal funds is a violation.
- Resident vs non-resident license?
- A producer is resident in their home state and obtains non-resident licenses elsewhere by reciprocity, usually without retaking the exam.
- What is misrepresentation as an unfair trade practice?
- Making false/misleading statements about a policy's benefits, terms, or the insurer's financial condition.
- What is rebating?
- Offering an inducement NOT specified in the policy (cash, gifts, services) to persuade someone to buy — a prohibited unfair trade practice.
- What is twisting?
- Inducing a policyholder to drop or replace a policy through MISREPRESENTATION, usually between different insurers.
- What is churning?
- Replacing a policy using the EXISTING policy's own values, with the SAME insurer, to generate commissions.
- Twisting vs churning?
- Twisting uses misrepresentation (often between different insurers). Churning uses the existing policy's own values with the SAME insurer.
- What is defamation (unfair trade practice)?
- Making false, malicious statements that injure a competitor's or an insurer's reputation.
- What is unfair discrimination?
- Charging different premiums or terms to individuals of the same class and equal risk.
- What is boycott, coercion, and intimidation?
- Acts that restrain trade or tend to create a monopoly — a prohibited unfair trade practice.
- Who is the Insurance Commissioner?
- The official (also Director or Superintendent) who heads the state Department of Insurance — licensing, disciplining, examining, and issuing cease-and-desist orders.
- Is the NAIC a regulator?
- No. The NAIC is NOT a regulator — it drafts MODEL LAWS that states must adopt to have legal force.
- What is the McCarran-Ferguson Act?
- Federal law leaving the regulation of insurance to the states (15 U.S.C. 1011-1015).
- What does the Fair Credit Reporting Act (FCRA) require of producers?
- Notice to a consumer when a consumer/inspection report is obtained, and an adverse-action notice when that report drives an underwriting decision.
- What does Gramm-Leach-Bliley (GLBA) require?
- Privacy notices to consumers and safeguarding of nonpublic personal financial information.
- What is the Unfair Claims Settlement Practices Act?
- An NAIC model act prohibiting unfair claim-handling practices, such as misrepresenting policy provisions or failing to act promptly on claims.
- What is an agent's appointment?
- An insurer's authorization for a licensed producer to transact business and bind coverage on its behalf.
- What is continuing education (CE) for producers?
- Required ongoing coursework (hours plus an ethics requirement set by each state) that a producer must complete to renew a license.
- Who administers the P&C producer license exam?
- Each state's Department of Insurance, delivered through a testing vendor (PSI, Pearson VUE, or Prometric). There is no national P&C license.
- What is commingling?
- Improperly mixing client premium funds with the producer's own personal or business funds — a breach of fiduciary duty.
- What is a cease-and-desist order?
- An order from the Commissioner directing a person to stop a prohibited act, such as an unfair trade practice.
- What is a market-conduct exam?
- A regulator's review of how an insurer treats policyholders — sales, underwriting, and claims practices — for compliance with state law.