FOI - Chapter 3 - New Slides

To prevent insolvency and protect policyholders.

Property and Casualty Insurance Compensation Corporation (PACICC)

<p>Changes increasing the risk of loss.</p> Signup and view all the answers

<p>Cancel policy (C), Adjust premium (D)</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers

<p>False description, misrepresentation of material fact, fraudulent omission.</p> Signup and view all the answers

<p>False (B)</p> Signup and view all the answers

Ensures consumer protection and market stability in the insurance industry, involving collaboration between federal and provincial governments.

The agency overseeing federally licensed insurers in Canada, focusing on financial stability and licensing standards.

The role of the federal government in insurance regulation, primarily focused on ensuring the financial stability of insurers and protecting policyholders.

The body responsible for regulating insurance in each Canadian province, including supervising contracts, licensing insurers, and monitoring their financial health.

The process of verifying an insurer's ability to meet its financial obligations, involving regular audits of assets, liabilities, and claims reserves.

An industry-funded organization that provides compensation for unpaid claims in case of insurer insolvency, up to a maximum of $250,000 per occurrence.

The principle that insurers and brokers must handle consumer funds responsibly and with trust, including retaining unearned premiums and refunding cancelled policies.

The process of regulating insurance contracts, including licensing, operating standards, and specific requirements for different insurance types.

The Act governing insurance policies in Canada, setting standards for content, parties, coverage, premiums, and subjects.

Mandatory rules included in fire insurance policies to define the relationship between the insurer and insured, covering aspects like misrepresentation, material change, and termination procedures.

A situation where false information or omissions in an insurance application can void the contract, especially if related to a subsequent loss.

An event or circumstance significantly increasing the risk of loss for an insured, requiring prompt notification to the insurer.

The process of ending an insurance policy, with different rules governing termination by the insurer or insured.

The insured's responsibility to prevent further damage to insured property after a loss, along with the insurer's rights to assess loss and contribute to salvage efforts.

A situation where a claim is deliberately fabricated or misrepresented to gain an unfair advantage, leading to the entire claim being voided.

The insurer's right to access insured property for loss assessment, although the insured retains control of the property.

A process for settling disputes between the insurer and insured regarding the value of a loss, but not coverage.

The timeframe for the insurer to pay a claim, typically within 60 days of receiving a completed proof of loss.

The insurer's option to repair, rebuild, or replace insured property instead of providing a cash payment.

The act of intentionally misleading an insurer in an insurance application, leading to a void contract if the misrepresentation is material to a loss.

Changes to the terms or conditions of an insurance policy must be in writing and authorized by the insurer, with written agreements required for interim changes.

The insured's responsibility to promptly inform the insurer of any significant changes that increase the risk of loss, such as changes in property use or introduction of hazardous activities.

Insurer-initiated termination requires a pro-rata refund, while insured-initiated termination results in a short-rate refund, both requiring prompt processing.

The insurer assumes the right to recover losses from a third party after paying a claim, ensuring fairness and reducing costs.

Notices to the insurer must be in writing and sent to the head office or chief agency, while notices to the insured must be delivered personally or by registered mail.

Insurer must prove deliberate intent to deceive when alleging fraud, as honest mistakes do not void claims.

Reporting the loss promptly, submitting detailed proof of loss, and taking steps to prevent further damage are the insured's responsibilities after a loss.

The insurer can choose to repair or replace the insured property instead of paying cash, but must communicate this decision in writing and begin repairs within 45 days.

The insured must promptly notify the insurer of the loss, submit detailed proof of loss, and take reasonable steps to salvage the property.

Claims made with intent to deceive are invalidated, while honest mistakes do not void the claim. The insurer must prove intent.

If the insured is absent or unable, their agent can give notice. Other parties may give notice if they are entitled to the claim.

The insured must take steps to salvage the property, and the insurer shares the reasonable salvage expenses, but there's no requirement to risk personal safety.

The insurer has the right to access the property for assessment, but the insured retains control. The insured cannot abandon the property without insurer consent.

A formal process for resolving disputes about the value of a loss, not coverage, initiated by a written request and governed by the Insurance Act.

Claims must be paid within 60 days of receiving a complete proof of loss, although some policies may specify shorter periods.

The insurer can opt to repair, rebuild, or replace insured property instead of paying cash, but must notify the insured within 30 days of the proof of loss and begin repairs within 45 days.

Legal action related to an insurance loss must be initiated within one year of the loss, although some legislation may allow a longer period.

Notices to the insurer must be sent to the head office or chief agency, while notices to the insured must be delivered personally or by registered mail.