Chapter 1: Basics Flashcards

1
Q

Define Reserves

A

Accounting measurements of an insurer’s future obligations to its policyholders (what is paid to a policyholder when they need it)

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2
Q

Define liquidity

A

The insurance company’s ability to make unpredictable payments to the policyholder

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3
Q

Describe Private Insurance Companies - Commercial

A
  • Commercial insurers offer many types of insurance.

- Multi-line insurers sell more than one type

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4
Q

Define Stock Companies - nonparticipating

A
  • Private organization

- Organized under state law to make profit for stockholders

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5
Q

Define Mutual Companies - Participating

A
  • Also organized under state laws
  • No stockholders (policyholders are owners)
  • Both costumer and an owner
  • Can participate in aspects of company and receive dividends (this is the participating part)
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6
Q

Define Strong Assessment Mutual/Insurers

A
  • Charges a premium at the beginning of the policy period

- This results in a policyholder either receiving money (dividend) or owing money

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7
Q

Define Reciprocal Insurers

A
  • Organized by ownership of policyholders

- Policyholders insure the risk of other policyholders

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8
Q

Define Lloyds of London

A

Acts as an arena for settling claims and disputes, provide coverage that may not be available in certain areas and put together underwriting information

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9
Q

Define Reinsurers

A
  • Insuring of insurance companies
  • Transfers a portion of risk to another company
  • Ceding company transfers risk to reinsurer (another company)
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10
Q

Define Captive Insurer

A

An insurance company owned by a parent firm for the purpose of insuring that parent firms losses

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11
Q

Define Risk Retention Group (RRG)

A

Mutual insurance company formed to insure people in the same occupation

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12
Q

Define Fraternal Benefit Societies

A
  • Membership based on religious, national or ethnic lines
  • Originally to help poorer members
  • Must be nonprofit, have a lodge system with ritualistic work and must have elected officers
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13
Q

Define Industrial Insurers

A
  • Specializes in a particular type of insurance
  • Small accounts ($1,000 to $2,000)
  • Premiums paid weekly
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14
Q

Define Service Providers

A
  • They sell medical and hospital care services not insurance
  • Pay a premium for services provided at a hospital or physician participating in the plan
  • Health maintenance organization (HMO) is also a service provider (they stress preventative health care)
  • Preferred Provider Organization (PPO) is the third type. Discounts or special services when going to a certain health care provider
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15
Q

Define Government as Insurer

A
  • Both federal and state governments
  • Ranges from crop insurance to savings and loans
  • includes social security and Medicare/Medicaid
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16
Q

Define Self-Insurers

A
  • Self-funded insurance
  • Often used by large companies for pension plans and some health insurance plans
  • Company will only use insurance company when they suffer a maximum loss
17
Q

How is insurance sold?

A
  • Mostly agents who present products and services for an insurance company
  • Agents represent the insurers and brokers represent the buyers
  • Captive career agents work for a company
  • Independent agents sells products from many companies and works for themselves
18
Q

Define Career Agency System

A
  • Branches of major stock and mutual insurance companies that represent a specific area
  • Employees are recruited, trained and supervised by members of the agency or a general agent
19
Q

Define Personal Producing General Agency System

A

Similar to career agency system but they Do Not recruit, train and supervise

  • Employees only work for the system not the insurance company
20
Q

Define Independent Agency System

A
  • Independent agents represent any number of insurance companies through contracts
  • Receives commission for bussiness they produce
21
Q

Define direct selling method

A
  • Type of insurance sold through mass marketing or direct sale to the consumer
22
Q

1868 - Paul v. Virginia

A

Upheld the right of states to regulate insurance (insurance is not interstate regulated)

Example: New York cannot regulate an insurance company in Ohio

23
Q

1944 - United States v. Southeastern Underwriters Association

A

Changed Paul v. Virginia slightly

  • Nullified state regulations that were in conflict with federal legislation
  • Shifted power to federal government though
24
Q

1945 - The McCarran-Ferguson Act

A
  • Regulation by state is in the peoples best interest
  • However the federal government has a right to interfere if the insurance company is not being run effectively
  • Must have a legitimate reason to obtain personal information about a client
  • Penalty: $10,000 minimum for violation
25
1958 - Intervention by the Federal Trade Commission (FTC)
FTC lost this case They wanted to control advertising and sales of the health insurance companies
26
1959 - Intervention by the Securities and Exchange Commission (SEC)
- Variable Annuities | - Required insurance companies to conform to both SEC and state regulations
27
1970 - Fair Credit Reporting Act
- Rights to privacy - requires fair and accurate reporting information about consumers. This includes informing an applicant about any investigations being made - Protects consumer when denied coverage or charged higher rates - Penalty: $5,000 for violation
28
1999 - Financial Services Modernization Act
- This overturned The Glass-Steagall Act of 1933 - Financial Services Modernization Act allows commercial banks, investment banks, retail buyers and insurance companies to enter each other’s lines of business
29
Marketing and Sales Practices
The ethics and professionalism that requires an agent to protect consumers - Determine a clients needs and provide coverage to best suit these needs - Inform clients of all aspects of products provided - Full documentation - Ongoing relationship with client
30
What should be provided when meeting with potential clients?
- Buyers Guide (details on products offered) | - Policy Summary
31
What are the goals of the National Association of a Insurance Commissioners?
1. To encourage uniformity in state insurance laws and regulations 2. Assist in administration of those laws 3. Protect interests of policyowners 4. Preserve state regulation of the insurance business
32
What is the State Guaranty Associations job?
To protect consumers when an insurance company is unable to pay claims
33
What is the Advertising Code
- Put in place by the NAIC | - Prohibits misleading information when dealing with insurance sales and marketing
34
Claim settlement practices
These are regulated by State Insurance departments
35
What is the job of an insurance company?
To transfer risk from an individual or business to an insurance company
36
What are annuities?
They provide a stream of income by making a series of payments over a certain amount of time
37
Define Demutualization
The process of a mutual company being converted to a stock company
38
What are Independent Rating Services?
Credit agency rate financial strength of an insurance company based on claims, reserves and company profits. Companies are: - AM Best - Standard and Poor’s - Moody’s - Fitch