EVALUATION QUESTIONS AND ANSWERS SURE A+
✔✔Fraud - ✔✔Intentional lying or misrepresentation by policyholders or claim adjusters
in order to inflate a claims payment that would otherwise not be paid.
✔✔Incurred Expense - ✔✔Expenses that have already been used and have not yet
been paid. ALE claim is a reimbursement of Incurred Expense.
✔✔Loss Payee - ✔✔The party that money is to be paid in the event of a loss. Ex:
Mortgage company, lien holder
✔✔Notice of Loss - ✔✔Notice required by insurance companies immediately after an
accident or other loss. Part of the standard provisions defining a policyholder's
responsibilities after a loss.
✔✔Overhead and Profit - ✔✔Amount of money dedicated to a General Contractor's
cost of doing business and earning a profit.
The INS standard is typically 10% overhead and 10% profit.
Usually added to a loss that involves at least 3 trades and the repair process requires
coordination by a General Contractor.
Ex: A house floods. They need water mitigation, mold, and reconstruction. 3 trades.
✔✔Personal Lines - ✔✔Insurance protection for individuals and families, such as
Homeowner's and Auto.
✔✔Premiums - ✔✔Amount of money paid by the insured to obtain or maintain an
insurance policy.
✔✔Reserves - ✔✔A company's best estimate of what it will pay for claims.
✔✔Salvage - ✔✔Left over value of a claim when an INS company recovers and sells
property to reduce its financial loss.
, "Salvage Title"
✔✔Subrogation * - ✔✔The process by which an insurer can, after it has paid a loss
under the policy, recover the amount paid from any party (other than the insured) who
caused the loss or is otherwise legally liable for the loss.
Ex: You buy a dishwasher, the valve malfunctioned, you pay $5000 for damages to your
home. If you can prove that the defective valve from the manufacturer is responsible,
then you may be reimbursed all your money.
✔✔Umbrella Insurance - ✔✔A liability policy that protects more than one property.
Usually purely liability coverage covering both auto and home. You may get a lower
premium for insuring both under the same policy.
Also provides coverage for claims that may be excluded by other liability policies
including: False arrest, slander, invasion of privacy, and liability coverage for units you
own.
✔✔Umpire - ✔✔A person hired when two Appraisers cannot come to a final
determination during the Appraisal process.
✔✔Underinsurance - ✔✔Inadequate coverage by the policyholder. May result in
economic losses to the policyholder since the claim would exceed the max amount that
can be paid out by the insurance company.
✔✔Uninsured Motorist Coverage - ✔✔Pays if you are struck by someone who does not
have insurance. Also will pay if you are a victim in a hit-and-run.
✔✔Elements of a Legal Contract - ✔✔- Offer and Acceptance
- Competent Parties (minors, mentally ill, or under the influence are not competent)
- Legal Object (must be drawn for legal purpose and not against public policy. A
contract that insures stolen property is not a legal contract)
- Consideration (Mutual giving & taking. The insured's is the premium they pay, and the
insurer's is the promise to pay for a loss caused by a covered peril)
✔✔Offer and Acceptance - ✔✔An element of a Legal Contract in which one party offers
something and the other accepts.
✔✔Competent Parties - ✔✔An element of a Legal Contract in which minors, mentally ill,
or under the influence are not competent.
✔✔Legal Object - ✔✔An element of a legal contract that states it must be drawn for
legal purpose and not against public policy. A contract that insures stolen property is not
a legal contract.