Nyce - Personal Insurance

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Author:
Esaie
ID:
9677
Filename:
Nyce - Personal Insurance
Updated:
2010-03-14 17:53:07
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TIA Exam 5
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TIA Exam 5 - Nyce, Personal Insuramce
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  1. Coverages of Personal Auto Policy
    • Part A Liability Coverage
    • Part B Medical Payments Coverage
    • Part C Uninsured Motorists Coverage
    • Part D Coverage for Damage to Your Auto
    • Part E Duties After an Accident or Loss
    • Part F General Provisions
    • Additional coverages can be added
  2. Declarations´╗┐
    • Identi es parties, vehicles, and coverages provided
    • Insurance Company
    • Named Insured
    • Policy Period
    • Description of Insured Autos
    • Schedule of Coverages
    • Applicable Endorsements
    • Lienholder
    • Garaged Location
    • Rating Information
    • Signature of authorized legal representative of the insurer
  3. Punitive Damages
    • Awarded by court to punish wrong doers
    • Not permitted in some states because it does not punish the insured
  4. Compensatory Damages
    • Intended to compensate victim for harm actually su ffered
    • Special Damages: speci c out-of-pocket expenses
    • General Damages: non-speci c economic losses
  5. Prejudgment vs. Post Judgment Interests
    • Prejudgment
    • Subject to policy limit
    • Interest that accrues between when accident or suit occurs and judgment rendered
    • Considered part of award for damages

    • Post Judgment
    • Not subject to the policy limit
    • Interest that accrues between when judgment is rendered and payment is made due to the appeals process
    • Considered a supplementary payment
  6. Insured Persons
    • Named insured and family members
    • Any person using the named insureds covered auto
    • Any person or organization legally responsible for the acts of a covered person while using a covered auto
    • Any person or organization legally responsible for the named insureds or family members use of any auto or trailer
  7. Supplementary Payments
    • Cost of bail bonds
    • Premiums on appeal bonds and bonds to release attachments
    • Interest accruing after a judgment
    • Loss of earning for insureds attendance - up to $200 per day
    • Other reasonable expenses incurred at the insurers request
  8. Liability Coverage Exclusions
    1. Intentional Injury, 2. Property Owned or Transported, 3.Property Rented to, Used by, or in the Care of the Insured, 4. Bodily Injury to an Employee of an Insured, 5. Public or Livery Conveyance, 6. Garage Business, 7. Other Business Use, 8. Using a Vehicle without Reasonable Belief of Being Entitled to Do So, 9. Nuclear Energy Liability Loss, 10.Vehicles that have Fewer than Four Wheels or Are Designed Primarily for Off -Road Use, 11. Other Vehicles Owned by the Named Insured or Available for the Named Insureds RegularUse, 12. Vehicles Owned by or Available for Regular Use of Any Family Member, 13. Racing
  9. Describe Limit of Liability 100/300/50
    • Fi rst limit applies to BI to each person
    • Second limit applies to BI to all persons in each accident
    • Third limit applies to all property damage in each accident

    • 1. Limits will not be increased regardless of the number of insured persons, claims made, vehicles or premiums shown, or vehicles involved in an auto accident
    • 2. Provision also states no one entitle to duplicate payment for same elements of loss under Part A, Part B, Part C, or any underinsured motorist coverage provided by policy
  10. Medical Payment Coverage Insuring Agreement
    • 1. Insurer will pay reasonable and necessary medical and funeral expenses incurred by an insured because of BI caused by an accident (Incurred within three years from the date of the accident)
    • 2. Applies without regard to fault
    • 3. Paid for both the insured and other injured occupants of the insured's covered auto
  11. Medical Payment Coverage Insured Persons
    • 1. Named insured and family members: while occupying a motor vehicle; when struck as a pedestrian by a motor vehicle designed for public roads (if struck by a farm tractor, coverage does not apply)
    • 2. Any other person while occupying a covered auto (however, if insured is operating a nonowned vehicle, passengers are not covered under insureds med pay coverage (other than family members))
  12. Medical Payments Exclusions
    1. Motorized Vehicles with Fewer Than Four Wheels, 2.Public or Livery Conveyance, 3. Vehicles Used as a Residence or Premises, 4. Injury During the Course of Employment, 5. Other Vehicles Owned by the Named Insured or Available for the Named Insureds Regular Use, 6. Vehicles Owned by or Available for Regular Use of Any Family Member, 7. Occupying a Vehicle Without Reasonable Belief of Being Entitled to Do So, 8. Vehicles Used in the Business of the Insured, 9. Bodily Injury From Nuclear Weapons or War, 10.Nuclear Radiation Exclusion, 11. Racing
  13. Uninsured Motorists Coverage Insuring Agreement
    1. Insurer pays compensatory damages that the insured person is legally entitled to recover from the owner or operator of an uninsured motor vehicle because of BI caused by an accident 2. Punitive damages are speci fically excluded 3. UM coverage applies only if the uninsured motorist is legally responsible for the accident 4. UMPD is available in some states, subject to deductible
  14. Uninsured Motorists Coverage Insured Persons
    • Named insured and family members (also covered as pedestrians)
    • Any other person who is injured while occupying a covered auto
    • Any person legally entitled to recover damages because of BI to a person described in 1. or 2. (E.g., insured person is killed by an uninsured motorist, spouse could collect damages)
  15. Uninsured Motor Vehicles
    • Land Motor Vehicle or Trailer of any Type That Meets the Following:
    • 1. No BI insurance or bond applies to the vehicle at the time of the accident
    • 2. Policy or bond inforce, but limit for BI is less than required by the financial responsibility law in principally garaged state
    • 3. Vehicle is a hit-and-run vehicle, whose operator or owner cannot be identi ed that hits: Named insured or family member; A vehicle that the named insured or family member is occupying; The named insureds covered auto
    • 4. BI policy or bond applies at the time of the accident, but insurance company: Denies coverage; Is or becomes insolvent
  16. Uninsured Motorists Exclusions
    • No uninsured motorists coverage on vehicle
    • Primary coverage under another policy
    • Claim settled without insurers consent
    • Covered auto used as public or livery conveyance
    • Vehicle used without reasonable belief of being entitled to do so
    • Cannot benefi t workers compensation insurer
    • Punitive damages not paid
  17. Uninsured Motorists Limit of Liability
    • Limits shown are the most that will be paid regardless of the number of insured persons, claims made, vehicles or premiums shown, or vehicles involved in an auto accident (Prevents stacking, i.e., if insured has three cars on a PAP with UM coverage of $25,000 per person, insured hit by an uninsured driver can recover $25,000 not $75,000)
    • No person will receive duplicate payments for any loss under Parts A, B, or C
  18. Uninsured Motorists Other Insurance
    • Total amount paid will be no more than the highest limit of any of the policies providing coverage
    • Coverage for an accident involving a vehicle the named insured does not own is provided on an excess basis
  19. Provisions that Apply If Uninsured Coverage Available Under Multiple Policies
    • Total amount paid will be no more than the highest limit of any of the policies providing coverage
    • Coverage for an accident involving a vehicle the named insured does not own is provided on an excess basis
    • When named insureds policy and other policies provide coverage on a primary basis, each policy will contribute proportionately to the insureds recovery
    • When named insureds policy and other policies provide coverage on an excess basis, each policy will contribute proportionately based on the excess limits
  20. Elements of Arbitration
    • Both insurer and insured must agree to arbitration
    • Each party selects an arbitrator
    • The two arbitrators select a third
    • Decision agreed to by two of the three arbitrators is binding as to entitlement and amount of damages
    • Decision is not binding if the amount of damages exceeds minimum limit for BI speci ed by the states financial responsibility law
  21. Purpose of Underinsured Motorists Coverage
    • To cover insured in situations which a negligent driver meets minimum required financial responsibility limits but are insuffcient to pay the insured's damages (At-fault motorist would not be considered uninsured)
    • E.g., Victim receives a $75,000 judgment against an at-fault motorist who has a $25,000 insurance limit, which meets the state minimum required. UIM makes up the diff erence.
  22. UM/UIM State Variations
    • Mandatory or Optional Coverage
    • Limits Trigger
    • Damages Trigger
    • Stacking
  23. Other-Than-Collision (OTC)
    • De finition: Coverage for auto physical damage losses that are not caused by collision and are not speci cally excluded by the policy
    • Examples: Missiles or falling objects; Fire; Theft or larceny; Explosion or earthquake; Windstorm; Hail, water or flood; Malicious mischief or vandalism; Riot or civil commotion; Contact with a bird or other animal; Breakage of glass
  24. Collision and OTC Deductibles are used to...
    • Reduce small claims
    • Hold down premiums
    • Encourage the insured to be careful in protecting his or her car against damage or theft
  25. Transportation Expenses
    • Provides reimbursement of up to a max of $600 for each covered loss for temp transportation expenses, such as auto rental fees or taxi fares, up to $20 per day
    • When loss involves a nonowned auto and an insured is legally responsible, insured's PAP will pay for the owner's transportation expenses, up to $20 per day
    • If insured only has OTC, will pay transportation expense in event of OTC loss
    • Applied without application of a deductible; however there is a waiting period
  26. Exclusions to Part D of PAP
    1. Public or Livery Conveyance, 2. Wear and Tear, Freezing, Mechanical or Electrical Breakdown, and Tire Damage, 3. Radioactive Contamination or War, 4. Electronic Equipment Designed for the Reproduction of Sound, 5. Equipment Designed for the Reception and Transmission of Audio, Visual, or Data Signals, 6. Media and Accessories, 7. Government Destruction or Con scation, 8. Camper Body or Trailer Not Shown in the Declarations, 9. Nonowned Auto Used Without a Reasonable Belief of Permission, 10. Radar and Laser Detection Equipment, 11. Customizing Equipment, 12. Nonowned Auto Used in the Auto Business, 13. Racing, 14. Rental Vehicles
  27. General Duties of Insured After an Accident or Loss
    • Give prompt notice
    • Cooperate with the insurer
    • Submit legal papers to the insurer
    • Agree to physical examination, if requested
    • Provide examination under oath, if required
    • Authorize release of medical records
    • Proof of loss
  28. Additional Duties for Uninsured Motorists Coverage After Accident or Loss
    • Notify police
    • Submit legal papers
  29. Additional Duties for Physical Damage Coverage After Accident or Loss
    • Prevent further loss
    • Notify policy
    • Permit inspection and appraisal
  30. Elements of Insurers Right to Recover Payment (i.e. Subrogation)
    • Insurers right to recover payment from a negligent third party
    • When insurer pays insured, insurer takes over right to collect damages from responsible party
    • Subrogation provision does not apply to physical damage coverages in regard to any person who is using a covered auto who is entitled to do so
    • Person cannot recover from both insurer and another party; must reimburse insurer
  31. Types of Termination
    • Cancellation
    • Nonrenewal
    • Automatic termination
    • Other termination provisions
  32. Steps in Determining the PAP Premium
    • Determine what classi cation will apply to the driver
    • Determine what model year and symbol will apply to the vehicle
    • Determine which territory will apply
    • Look up the Base Rates in the rate pages
    • Multiply the base rate by the rating factor
    • Add the appropriate expense fees
    • Add the surcharge, if applicable under the certifi ed risk rule
  33. Characteristics Represented by the Secondary Classi cation of PAP
    • Performance level of the vehicle
    • Single car vs. multicar risk
    • Classi cations related to Safe Driver Insurance Plan

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