Ch 1 - Insurance Regulations - 15% of exam

Question 1

PA bond requirement

Answer 1

$20,000

Question 2

NJ bond requirement

Answer 2

$10,000

Question 3

PA # of days to cancel (rescind)

Answer 3

3 days

Question 4

NJ # of days to cancel (rescind)

Answer 4

4 days

Question 5

Must all NJ Contracts be written?

Answer 5

Yes (PA ALSO?)

Question 6

Where are the various methods listed top the insured that show them ways they can cancel, and what are they?

Answer 6

On the contract. They may email, call, leave a vm, fax.

Question 7

Where are all records kept?

Answer 7

Bensalem

Question 8

2 days to send to ins. carrier, relates to what?

Answer 8

The # of BUSINESS days the P.A. firm has to notify the insurer of a contract.

Question 9

If someone comments or asks about other companies, what do you do?

Answer 9

We’re not allowed to comment.

Question 10

What is the amount that fines can be issued for per item to a P.A. under the PUBLIC ADJUSTER ACT?

Answer 10

$1,000 per item.

Question 11

What’s the purpose of the Unfair Insurance Practices Act?

Answer 11

To regulate trade practices in the business of insurance by defining practices that constitute unfair methods of competition, or unfair practices.

Question 12

What are the amounts that fines can be issued for per item to a P.A. under the UNFAIR INS PRACTICES ACT if the P.A. did NOT know, or should have reasonably known, was a violation?

Answer 12

$1,000 per item, not to exceed $10,000 over six mos.

Question 13

What are the amounts that fines can be issued for per item to a P.A. under the UNFAIR INS PRACTICES ACT if the P.A. DID KNOW, or should have reasonably known, was a violation?

Answer 13

$5,000 per item, not to exceed $50,000 over six mos.

Question 14

What’s the amount a fine can be issued per item to a P.A. under the UNFAIR INS PRACTICES ACT for violating a Cease & Desist Order while it’s in effect?

Answer 14

$10,000 per item.

Question 15

List the 9 examples in the Study Guide that fall under unfair or deceptive trade practices? (under Unfair Ins. Prac, Act)

Answer 15

1) Publishing false illustrations/sales presentations. 2) Misrep of policy benefits, condition or dividend projections. 3) Misrep the name/title/class of a policy. 4) Circulate false/malicious info about a competitor. 5) Deceptive Advertising 6) Making false/derogatory statements of the finances of a person. 7) Entering into an agreement to boycott, coerce, intimidate, or monopoly. 8) Filing false statements of the financial condition of any person. 9) Rebating and inducements

Question 16

Within how many days must an insurer complete an investigation? If they need more time what must they do?

Answer 16

30 WORKING days to complete the investigation. If more time needed, insurer must send a written notice within 30 days of notification of the claim, stating reasonable explanation for delay and state when a decision of the claim may be expected. They have 45 days to do this, and must repeat every 45 as needed.

Question 17

If a P.A. happens to also be a contractor, what are the rules to be followed around repairing his own house while waiting for a decision from an insurer?

Answer 17

He’s not allowed to repair prior to: 1) A written decision or 2) Payment of settlement is received. Whichever happens first enables him to begin repair. (IS THIS THE CORRECT POINT OF THE QUESTION?)

Question 18

Notes: 10 days to notify..REFERS TO WHAT?

Answer 18

?

Question 19

After a cancellation, the P.A. has how many days to return “negotiable instruments”, and what are examples of them?

Answer 19

15 days. Examples: pictures, contracts, deeds.

Question 20

How many days does a P.A. have to notify an insurer of an executed contract?

Answer 20

2 BUSINESS days.

Question 21

Who are checks made out to, and in what order does the check go?

Answer 21

P.A. firm, then Mortgage co., then the insured. (CHECK THIS)

Question 22

Notes: “Re-read Misreps of Policy Provisions pg. 7, is wordy.”

Answer 22

NEEDED FOR EXAM??

Question 23

What do I have to know about “The Declarations Page”?

Answer 23

??

Question 24

Name the 4 responsibilities of the insured under “Duties in the Event of a Loss?”

Answer 24

1) Notify of loss 2) Protect property from further damage 3) Separate damaged from undamaged property 4) Assign a value (The P.A. re-assigns an adjusted value though right? IS INSURED REQUIRED TO ASSIGN AN ESTIMATED VALUE IN THE INITIAL PHONE CALL SUBMITTING THE CLAIM? If yes, can this affect payout?)

Question 25

What are the 2 types of adjusters an ins. co generally assigns?

Answer 25

1) Company ins. adjuster 2) Independent ins. adjuster (2 usually handles overflow claims)

Question 26

of days ins. co. have to acknowledge receipt of a claim? (unless payment is made within this period)

Answer 26

10 WORKING. (ASK IF pg 10 is accurate…ins. co. timetables are “working” days, whereas P.A.’s are “calendar” and “business”???

Question 27

of days ins. co. has to provide claims forms and reasonable assistance?

Answer 27

10 WORKING days.

Question 28

of days ins. co. have to respond to an ins. dept. inquiry?

Answer 28

15 WORKING days.

Question 29

of days ins. co. has to accept/deny a claim after proof of loss is executed?

Answer 29

15 WORKING days.

Question 30

of days insured (or P.A.) has to cancel a contract?

Answer 30

3 CALENDAR days in PA. (In NJ: 4 CALENDAR days.)

Question 31

of days P.A. has notify insurer of contract?

Answer 31

2 BUSINESS days.

Question 32

After a cancellation, the P.A. has how many days to return payments to the insured?

Answer 32

15 BUSINESS days. (WHAT SSENARIO WOULD WE TAKE A CHECK FROM THE INSURED, DONT WE GET PAID BY THE INSURER?)

Question 33

ANY OTHER CH1 PAGES TO READ?

Answer 33

CHECK THIS.

Question 34

Do Ch. 1 Practice Test.

Answer 34

Done.

Question 35

How many Ch. 1 Exam Q’s?

Answer 35

?