Introduction to Risk Management & Related Legal Issues Flashcards

Learning Objectives 5-1: Explain the steps of the risk management process and their importance. 5-2: Explain a rule of risk management. 5-3: Explain the elements of an insurable risk. 5-4: Explain the purpose of the underwriting process and its implications for the client. 5-5: Apply methods of handling risk in a given situation. 5-6: Identify the advantages and disadvantages of self-insurance. 5-7: Explain an essential legal liability term. 5-8: Analyze a given situation to identify th (62 cards)

1
Q

Concepts of Risk & Definition

A

Risk
the possibility of an adverse outcome (loss) e.g., damage to house

Peril
the cause of loss e.g., fire

Hazard
increases the likelihood of loss e.g., placing lit candles too close to curtains

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2
Q

The Risk Management Process

A
  1. Identify risk management goals
  2. Gather pertinent data to determine risk exposures
  3. Analyze and evaluate the information to identify risk exposures facing the client
  4. Construct a risk management plan
  5. Implement the plan
  6. Monitor/Update the plan
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3
Q

Define 1. Identify risk management goals

A

Decide precisely what the client wants from the risk

management program and set clearly defined objectives

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4
Q

Define 2. Gather pertinent data to determine risk exposures

A

Use data sheets, policy checklists, risk analysis questionnaires, and financial statements to learn as much as possible about the sources of risk exposure faced by the client

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5
Q

Define 3. Analyze and evaluate the information to

identify risk exposures facing the client

A

Examine each of the client’s assets, contracts, and

activities, looking for exposures

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6
Q

Define 4. Construct a risk management plan

A

Consider alternative risk treatment approaches for each exposure and select which should be used for each risk

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7
Q

Define 5. Implement the plan

A

Encourage the client to make a decision about your

recommendations and act on them

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8
Q

Define 6. Monitor/Update the plan

A

As the client’s circumstances change, review and

update the plan

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9
Q

Rules of Risk Management
-Don’t risk more than you can afford
to lose

A

• Transfer potentially devastating losses whose severity cannot be reduced (i.e., the large-loss principle).

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10
Q

Rules of Risk Management

-Consider the odds

A

The higher the probability of loss, the

less appropriate is risk transfer.

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11
Q

Rules of Risk Management

-Don’t risk a lot for a little

A

• There should be a reasonable
relationship between the cost
of transferring risk and the
value to the transferor.

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12
Q

Elements of an Insurable Risk

A

Law of large numbers:
1. There must be a sufficiently large number of homogeneous exposure units to make the losses reasonably predictable.

The loss produced by the risk
must be:
2. definite and measurable
3. fortuitous or accidental
4. not catastrophic
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13
Q
Which of the following are elements of an
insurable risk for an insurance company?
I. The loss must be catastrophic.
II. The loss must be measurable.
III. The loss must be accidental.
IV. The loss must be inevitable.
A

a. I and II only
b. I and IV only
c. II and III only
d. II and IV only
e. II, III, and IV only

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14
Q

Purpose of the Underwriting Process

A

The underwriting process is meant to:
• assure that any risks insured will retain their
compliance with the elements of an insurable
risk after insuring.
• control adverse selection.
• assure that the risks considered for insurance
either:
o conform to the degree of risk priced,
o pay sufficient additional premium to make up for
risk brought to the pool in excess of that priced,
o are rejected if they fall too far outside
underwriting guidelines.

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15
Q

Implications of the Underwriting Process for the Client

A
  1. Underwriting guidelines are just that—guidelines.

o If there is a good reason your client should be
insured in spite of an apparent lack of compliance with a guideline, make this reason
known to the underwriter.
o With sufficient additional information, insurance
may be offered in spite of apparent noncompliance.

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16
Q

Implications of the Underwriting Process for the Client

A
  1. There are definite limits on what insurance can

be obtained for the client, regardless of what the client is willing to pay.

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17
Q

The Underwriting Process: 5 Sources of Information

A
  1. Application containing the proposed insured’s
    statements
  2. Recommendations of the agent or broker
  3. Investigations from an inspection company
  4. Cooperative information bureaus
  5. Physical examinations orinspections of properties
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18
Q

Methods of Handling Risk regarding Avoidance

A

Avoid the cause

Example: Don’t go skiing

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19
Q

Methods of Handling Risk Regarding Reduction

A
  1. Prevent control the loss
  2. Share risk (bearing only a portion of the risk through pooled resources

Example: Ski marked trails in protective gear
Incorporation (risk limited to financial participation)

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20
Q

Methods of Handling Risk Regarding Retention

A

Keep the risk

Example: Ski ( or other activity); insurance deductibles

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21
Q

Methods of Handling Risk Regarding Transfer

A

Transfer to another

Example: Buy insurance policy

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22
Q

Circumstances of Handling Risk on High Severity:

A

High Frequency of High Severity Risk:
Risk Avoidance or Risk Reduction
Low Frequency of High Severity Risk:
Risk Transfer

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23
Q

Circumstances of Handling Risk on Low Severity:

A

High Frequency of Low Severity Risk:
Risk Retention or Risk Reduction
Low Frequency of Low Severity Risk:
Risk Retention

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24
Q

Self-Insurance Advantages

A
  • Control of investment fund
  • Elimination of selling costs and insurer profit
  • Elimination of state premium taxes
  • Incentive to control and prevent losses
  • Losses incurred are deductible
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Self-Insurance Disadvantages
• Depletion of funds in high loss years • Deposits made into self insurance fund are not deductible • Need to replace all services provided by an insurer o impartial claims service o loss prevention services o consulting services o investment management services • Possible increased expenses
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Question 2 - Self-Insurance Which of the following are disadvantages of self-insurance? I. the lack of an impartial claims service II. the need to pay state premium taxes III. the elimination of selling costs IV. the need to duplicate services offered by an insurance company
a. I and III only b. I and IV only c. II and III only d. II and IV only e. I, II, and IV only
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Criminal & Tortious Behavior | What are the 2 Classes of Wrong
Public & Private
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Criminal & Tortious Behavior for Public Class: Note: 1. The same action can give rise to exposure of both types. For example, the unjustified shooting of an individual can give rise to a criminal action as well as to a tort action. 2. There is no insurance if you commit a public wrong or an intentional tort (with one exception related to malpractice).
Nature of Wrong: A crime—violation of criminal law Type of Redress: Jail term and/or fines
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Criminal & Tortious Behavior for Private Class: Note: 1. The same action can give rise to exposure of both types. For example, the unjustified shooting of an individual can give rise to a criminal action as well as to a tort action. 2. There is no insurance if you commit a public wrong or an intentional tort (with one exception related to malpractice).
Nature of Wrong: A tort—infringement of rights of an individual Type of Redress: Monetary damages
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Tort
An injury or wrong caused to another
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Intentional torts
Direct infringements on the rights of others, including assault and battery, libel, slander, or false arrest
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Unintentional torts
Injuries or losses caused to others resulting from negligence, carelessness, or creating hazardous conditions
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Trespassers
Persons who come onto the property of another | without right or consent
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Licensees
Persons on one’s property with stated or implied permission but not to further the purposes of the landholder
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Invitees
Persons entering property having an express or implied invitation to enter on business with the potential of benefiting the owner economically
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Negligence
Failure to behave as a reasonable and prudent | individual
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Res ipsa loquitur
A doctrine that allows the question of whether or not the plaintiff has carried his or her burden of showing, by a preponderance of the evidence, that the defendant should be held liable for negligence; application of the doctrine requires that the accident must (1) be of a type that normally does not occur without negligence; (2) be caused by an agency or instrumentality within the exclusive control of the defendant; and (3) not have been due to any voluntary action or contribution on the part of the plaintiff.
38
Attractive nuisance
A dangerous place, condition, or object that | is particularly attractive to children
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Negligence per se
Violation of a standard of care set forth in a statute protecting a class of persons to which the plaintiff belongs, and resulting in a type of harm the statute was intended to prevent
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Absolute (Strict) liability
Liability imposed regardless of negligence, resulting from extra hazardous activities or conditions
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Vicarious liability
One person becomes legally liable for the | negligent behavior of another
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Legal Defenses to Liability | Assumption of the Risk
A party recognizes the risk involved and voluntarily | undertakes the activity regardless, then another cannot be held liable for injury that occurs.
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Legal Defenses to Liability | Contributory negligence
Any negligence on the part of the injured party will defeat the claim
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Legal Defenses to Liability | Comparative negligence
Negligence on the part of the injured party will reduce the claim by the % of negligence.
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Legal Defenses to Liability | Last Clear Chance
An individual’s responsibility to warn someone regarding a potential loss; in other words to take the last clear chance words, to prevent the loss
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Legal Requirements for Enforceable Contracts
1. Offer and acceptance 2. Consideration 3. Legal object 4. Competent parties o void or voidable 5. Legal form
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Law of Agency as It Relates to Financial Planners as Express Authority
• Specifically conferred by contract | oral or written
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Law of Agency as It Relates to Financial Planners as Implied authority
• A client saying “take care of the matter” can be considered implied authority
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Law of Agency as It Relates to Financial Planners | as Apparent Apparent
• Ostensible authority o Can become an issue when the client believes the planner is acting under the express authority of a principal (e.g., and insurer or brokerdealer)
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Professional Liability
When a planner fails to conduct him/herself in a professional manner and causes harm to another, that planner will be considered negligent – If: • there is a legal duty to conform to a certain standard of conduct. o SEC, FINRA, CFP Board Code of Ethics, etc. • there is failure to conform to that standard. • there is a causal connection between the action and the resulting harm to a client. • there is actual loss, damage, or harm.
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7 Special Legal Characteristics of Insurance Contracts
1. Aleatory 2. Adhesion 3. Conditional o Conditions must be met for the policy to pay full benefit 4. Personal 5. Unilateral 6. Utmost good faith 7. Contract of indemnity (made whole) Except “valued policies” and “cash payment policies” This principle is enforced through legal doctrines and policy provisions, which include: • insurable interest, • actual cash value, • subrogation, and • “other insurance” provisions.
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Question 3 - Insurance Contracts | What is one legal requirement for an enforceable insurance contract?
a. The parties to the contract must give up goods or services of equal value. b. The applicant must be given the right to alter or change provisions in the contract. c. The applicant must be considered a competent party to make a valid contract. d. The insured must be of majority age for the contract to be valid. e. The performance of the contract cannot be contingent on the occurrence of an event that is subject to chance.
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The 5 Insurance Contract Sections and Provisions Term Conditions
• Spells out in detail the duties and rights of both parties
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The 5 Insurance Contract Sections and Provisions | Term Declarations
• Contains name of the insured, description and location of property, amount and description of coverage, amount of premium, the term of the policy, and its inception and termination dates
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The 5 Insurance Contract Sections and Provisions | Term Exclusions
States what the insurer will not do
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The 5 Insurance Contract Sections and Provisions | Term Insuring Agreement
• States that the insurer will pay for loss if it results from the perils covered
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The 5 Insurance Contract Sections and Provisions | Term Endorsements
• Special added provisions agreed upon between insured and insurer
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What are 5 Insurance Contract Sections and Provisions
1. Conditions 2. Declarations 3. Exclusions 4. Insuring agreement 5. Endorsements
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Question 4 - Doctrine of Waiver The doctrine of waiver provides for which one of the following remedies in settling insurance contract disputes?
a. The insurer may alter the contract provisions upon notifying the policyholder. b. The insurer may void the contract in cases of misrepresentation. c. The insurer may be held to any relinquishment of a contractual right. d. The insurer may be held only to those terms written in the contract. e. The insurer will not be allowed to contradict any prior position taken in court.
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Question 5 - Law of Agency Which one of the following statements about the law of agency is incorrect?
a. A power of attorney is an example of express authority. b. A telephone call from your client telling you to “take care of that matter” can be considered implied authority. c. Authority to act as an agent cannot be implied simply because the client fails to object to a series of known, unauthorized acts. d. An agent can have apparent authority if the principal fails to notify the agent’s clients directly, stating that the agent’s contract with the principal has been terminated.
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Question 6 - Doctrines of Liability Barbara Barnett left her car parked on top of a hill while visiting at a friend’s house. Unfortunately, she forgot to apply her emergency brake and her car rolled down the hill, injuring two children who were playing. Which one of the following doctrines may influence Barbara’s liability in this situation?
a. assumption of risk b. strict liability c. intentional negligence d. negligence e. attractive nuisance
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Question 7 - Insurance Contracts | What is one characteristic of an insurance contract?
a. The insurer and the insured exchange dollars of equal value. b. It is a bilateral contract. c. The insurer receives the benefit of the doubt in interpretations of ambiguity in the contract. d. The insured must meet certain conditions in order to collect for losses. e. The insured has the right to change policy provisions unilaterally.